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  • Oh Aetna Better Health Prior Authorization Form 2017

Get Oh Aetna Better Health Prior Authorization Form 2017-2025

Rgent requests (required within 24 hours), call Aetna Better Health of Ohio at 1-855-364-0974. For Inpatient Acute Physical Health and Behavioral Health Requests for ACT (H0040), IHBT (H2015), and SUD Residential Treatment (H2034, H2036) please use fax 1-855-734-9393. For all other Physical Health and Behavioral Health Service authorization requests please use fax 1-855-734-9389. MEMBER INFORMATION Name: ID Number Da.

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Learn about the benefits and services available to you as an Aetna Better Health of Ohio member.

Call Member Services/Provider Services at 1-855-364-0974 (TTY: 711), 24 hours a day, seven days a week (and during all holidays). The call is free.

Family Size Monthly Income* 1 $1,883 2 $2,555 3 $3,228 4 $3,900 5 $4,573 6 $5,245 7 $5,918 8 $6,590 9 $7,263 10 $7,935 Families with monthly incomes higher than the amount in the first column, but lower than the amount in the second column MUST apply if they do not have private health insurance.

Because Aetna Better Health of Ohio manages both Medicare and Medicaid coverage, our members only have to work with us. We take care of it all, including dental, vision and mental health benefits, and more. It also simplifies your office processes.

Aetna Better Health of Virginia is part of Aetna® and the CVS Health® family, one of our country's leading health care organizations. We've been serving people who use Medicaid services for over 30 years — from kids, adults and seniors to people with disabilities or other serious health issues.

Aetna Better Health of Ohio, a MyCare Ohio plan (Medicare-Medicaid Plan), is a health plan that contracts with Medicare and Ohio Medicaid to provide benefits of both programs to enrollees. If you have questions, please call Aetna Better Health of Ohio at 1-855-364-0974 (TTY: 711), 24 hours a day, 7 days a week.

How do I file a claim? You must file claims within 365 days from the date of service. For inpatient claims, the date of service refers to the member's discharge date.

You can send a secure fax to us at 833-928-1259. For appeals: Tell us your name, ID number, the date of your Notice of Action letter, information about your case and why you're asking for the appeal.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
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