Aetna Better Health Illinois

Providers

Forms

> Limitations on Services - HFS Form 2390
> Sterilization - HFS Form 2189
> HFS Form 2189S (sterilization form in Spanish)
> Hysterectomy - HFS Form 1977
> IL Facility Application
> IL Provider Applicaton
> Member Transition of Care Form (English/Spanish)
> Member Care Information Registration Form
> My Care Information Member Authorization Form- English
> My Care Information Member Authorization Form- Spanish
> Pharmacy Prior Authorization Request
> Prior Authorization Form

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