Get Oh Aetna Better Health Prior Authorization Form 2022-2025

Completing the OH Aetna Better Health Prior Authorization Form online is an essential process for obtaining necessary health services. This guide provides clear and detailed instructions to help users easily navigate and fill out the form accurately.

Follow the steps to fill out the OH Aetna Better Health Prior Authorization Form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Fill in the ‘Date of Request’ section with the current date.
3. Provide information regarding urgent requests by calling Aetna Better Health of Ohio if the service is required within 24 hours.
4. Select the appropriate ‘Place of Service’ from the given options such as Skilled Nursing Facility, Nursing Facility, Custodial Care Facility, Home, or Office.
5. Complete the ‘Member Information’ section by entering the member's name, date of birth, any other insurance details, and the ID number.
6. In the ‘Requesting Physician or Provider Information’ section, add the referring or requesting provider's name, address, telephone number, fax number, specialty, and National Provider Identification (NPI). Include the contact person’s details as well.
7. In the ‘Referral / Authorization Information’ section, fill out the problem/diagnosis with the appropriate ICD-10 codes, the requested procedure/test with CPT codes, the date of the appointment or service, the number of visits required, and the type of procedure, selecting from Inpatient, Outpatient, In-Office, or Other.
8. Include any necessary clinical information such as clinical notes, lab reports, and X-ray reports. Ensure you attach additional pages if needed.
9. Review all entered information for accuracy, then proceed to save changes, download, print, or share the completed form as required.

Start filling out your documents online today to ensure timely processing.