Forms
Below are forms that you may need as a member of Aetna Better Health of Ohio. These forms can help you manage claims, access information and more. If you need a form not listed here, contact us.
Notice of Privacy Practices (Eng/Spa)
Appointment of Representative Form
Authorization to Release Protected Health Information (PHI)
Authorization to Release Psychotherapy Notes
Behavioral Health Prior Authorization Form
Prescription Drug Mail Order Form (English & Español)
Coverage Redetermination Request Form
Medicare Part D Prescription Claim/Reimbursement Form (English & Español)
Member Advisory Committee Application