Prior authorization

How to obtain prior authorization

As an Aetna Better Health provider, you need to prescribe medically necessary therapy or medications for a member. Some of these services require prior authorization.

A current list of the services that require authorization is available via the secure web portal. If you have questions about what is covered, consult your provider handbook or call 1-866-212-2851 (ICP) or 1‑866‑600-2139 (Premier Plan) for more information.

If covered services and those requiring prior authorization change, you will receive at least 60 days’ advance notice via provider newsletter, e-mail, updates to this website, letter (U.S. mail), telephone call or office visit.

Remember, prior authorization is not a guarantee of payment. Unauthorized services will not be reimbursed.

Tips for requesting authorizations

• ALWAYS verify member eligibility prior to providing services.

• Complete the appropriate authorization form (medical or pharmacy).

• Attach supporting documentation when submitting.

You can fax your authorization request to 1-855-320-8445. You can also submit service authorizations through our secure web portal.

Subcontractors

Aetna Better Health works with certain subcontractors to coordinate services that are provided by entities other than Aetna Better Health, such as transportation, vision or dental services. If you have an Aetna Better Health member that needs one or more of these services, please contact Member Services at 1-866-212-2851 (ICP) or 1‑866‑600-2139 (Premier Plan) for more information.