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The document is a Prescription Drug Prior Authorization Request Form for Aetna, detailing the process for submitting requests for prior authorization of prescription drugs, including specialty drugs. It provides contact information for faxing and online submission, outlines patient and prescriber information required, and specifies conditions under which prior authorization is needed, particularly regarding opioid dependence treatment. Additionally, it includes compliance statements related to civil rights and language services.

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Versions	Form popularity	Fillable & printable
2019	4.8 Satisfied (45 Votes)
2016	4.3 Satisfied (57 Votes)

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What happened to Aetna insurance Company?

2018: On November 28, 2018, CVS Health completed the acquisition of Aetna. The companys ticker AET is delisted from the NYSE.

Is EviCore owned by Aetna?

EviCore by Evernorth is a medical benefits management company owned by Cigna. It is based in Bluffton, South Carolina, United States. The company reviews prior authorizations for specialized medical procedures on behalf of insurers.

What is the number for 1 800 353 1232?

For credentialing questions, call the Aetna credentialing and application management team at 1-800-353-1232 (TTY: 711). Send dental network inquiries to Aetna Dental West, 21215 Burbank Blvd., Suite 620, Woodland Hills, CA 91367 or fax to 1-866-445-4387.

What is the number for 1 800 282 5366?

If youd like to get a total for the number of appeals, grievances and exceptions filed with Aetna Medicare, call us at 1-800-282-5366 (TTY: 711). Calls are answered 7 days a week, 8 AM to 8 PM.

What is the number for Aetna prior authorization?

For more help understanding what you need prior authorization for, call the Member Services number on your member ID card, 1-833-570-6670 (TTY: 711). Were available between 8 AM and 8 PM, 7 days a week. Are you happy with your Aetna plan?

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What number is 1 800 624 0756?

National Medicare Dentist Line: Have a question? Call the National Medicare Dentist Line at 1-800-624-0756.

What is prior authorization Aetna?

Prior authorization is a process used by all health plans to promote quality care and manage health insurance coverage. Its also called precertification or preapproval. Health insurers, like Aetna, assess the medical need of services and treatments.

How do I call Aetna prior authorization?

Ask for PA by calling us at 1-855-456-9126 (TTY: 711).

Aetna prior 2025

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What is the number for Aetna prior authorization?

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What number is 1 800 624 0756?

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