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  • Aetna - Medical Exception/prior Authorization/precertification Request For Prescription

Get Aetna - Medical Exception/prior Authorization/precertification Request For Prescription

Medical Exception/ Prior Authorization/Precertification* Request for Prescription MedicationsFax this form to: 18772699916 OR Submit your request online at: https://www.availity.com Visit www.aetna.com/formulary.

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Related links form

COMNAVCRUITCOMINST 1136.2Q 2011 DA 1222 2000 DA 1248 2007 DA 137-1 2010

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What is a Prior Authorization? A prior authorization (PA), sometimes referred to as a “pre-authorization,” is a requirement from your health insurance company that your doctor obtain approval from your plan before it will cover the costs of a specific medicine, medical device or procedure.

For some services, your PCP is required to obtain prior authorization from Aetna Medicare. You'll need to get a referral from your PCP for covered, non‐emergency specialty or hospital care, except in an emergency and for certain direct‐access service. There are exceptions for certain direct access services.

To initiate a request, submit electronically on Availity or call our Precertification Department. Submit your medical records to support the request with your electronic submission. We've made it easy for you to authorize services and submit any requested clinical information.

M EX = Medical Exception - This means the member or treating physician or health care professional must obtain a medical exception from Aetna, in order for the medication to be eligible for coverage. Medical Exception criteria apply to non-formulary drugs for members enrolled in or covered by closed benefits plans.

First, your doctor will get the process started When you see your doctor, they'll help you get the prior authorization you need. We make it easy, so you can receive a timely decision. And we'll stay in touch throughout the review process.

After logging in to your secure member website, follow these steps: Click "Claims Center," then "Submit claims" Complete your claim online. Copy, scan and upload your supporting documents, including itemized bills, original receipts. Click "submit claim" to complete the process.

The healthcare provider is usually responsible for initiating prior authorization by submitting a request form to a patient's insurance provider. As mentioned in the “How does prior authorization work?” section above, this will then often prompt a time-consuming back and forth between the provider and payer.

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© Copyright 1997-2025
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3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232