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Prior authorization

Prior authorization (PA) is required for some in-network care and all out-of-network care. We don’t require PA for emergency care. You can find a current list of the services that need PA on the Provider Portal. You can also find out if a service needs PA by using ProPAT, our online prior authorization search tool.

 

Search ProPAT

 

Questions?

Check out your provider manual. Or just contact us.

Tips for requesting PA

Tips for requesting PA

A request for PA doesn’t guarantee payment. We can’t reimburse you for unauthorized services. You can make requesting PA easier with these tips:

 

How to request PA

Online

 

Ask for PA through our Provider Portal.

 

Visit the Provider Portal

 

By phone

 

Ask for PA by calling us at 1-866-874-2567 (TTY: 711)

 

By fax

 

Download our Medicaid PA request form (PDF). Then, fax it to us at 866-603-5535 

 

And be sure to add any supporting materials for the review. 

 

Online

 

Ask for PA through our Provider Portal.

 

Visit the Provider Portal

 

By phone

 

Ask for PA by calling us at 1-855-676-5772 (TTY: 711).

 

By fax

 

Download our Medicare-Medicaid (Aetna Better Health Premier Plan) PA request form (PDF). Then, fax it to us at 1-844-241-2495.

 

And be sure to add any supporting materials for the review. 

 

 

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