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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).

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Tips for requesting authorization

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

For more information

Consult your provider manual (PDF). Or call us at 1-866-329-4701 (TTY: 711).

How to request prior authorization

Here are the ways you can request prior authorization:

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.