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Prior authorization
Aetna Better Health® of Illinois requires prior authorization for select acute outpatient services and planned hospital admissions, but not for emergency services. A current list of the services that require authorization is available on the Provider Portal, through our Provider Prior Authorization Tool (ProPAT).
Tips for requesting authorization
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Tips for requesting authorization
A request for prior authorization is not a guarantee of payment. Unauthorized services will not be reimbursed. You can make prior authorization requests easier by:
- Registering for the Provider Portal if you haven’t already
- Verifying member eligibility prior to providing services
- Completing the prior authorization form for all medical requests
- Attaching supporting documentation when submitting
Medicaid Prior Authorization Requirement Grid (PDF)
MLTSS Prior Authorization Requirement Grid (PDF)
LTSS Prior Authoziation Requirement Grid (PDF)
How to request prior authorization
Here are the ways you can request prior authorization:
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Online
You can request prior authorization through our Provider Portal.
By Phone
You can request prior authorization by calling us at 1-866-329-4701 (TTY: 711).
By fax
Download our prior authorization form. Then, for Physical Health fax it to us at 1-877-779-5234 or for Behavioral Health fax it to 1-844-528-3453 with any supporting documentation for a medical necessity review.