Get Precert Request Form - Aetna

This guide provides clear instructions for completing the Precert Request Form - Aetna online. By following these steps, you will ensure that you fill out the form accurately and efficiently, facilitating a smoother approval process for prescription medications.

Follow the steps to successfully complete the form.

1. Press the ‘Get Form’ button to access the form and open it for editing.
2. Begin by entering the patient's name and insurance ID number in the designated fields. Ensure that the information is accurate and current.
3. Fill in today’s date and the patient's date of birth to provide necessary identification information.
4. Enter the physician's name and signature. Include the clinic's address and telephone number for verification purposes.
5. Indicate the specialty of the physician as well as the office contact and their title.
6. In the section for the drug requested, specify the medication and dosage schedule. Be clear to avoid confusion.
7. State the desired duration of therapy, ensuring that this reflects the treatment plan.
8. Provide the diagnosis and medical justification, including any relevant ICD-9 codes and lab reports. If additional space is needed, attach extra pages.
9. Complete the section regarding previous therapy and outcomes. Include specific results for lab tests such as KOH, PAS, or fungal cultures if applicable.
10. Indicate whether the patient is experiencing pain by checking 'Yes' or 'No'. Provide any additional information in the space provided.
11. Review all filled sections for accuracy and completeness. Once satisfied, proceed to save changes, download, print, or share the completed form as needed.

Complete your forms online for a streamlined process today.