Aetna Better Health values the quality care that health care providers give our members. To support that effort, Aetna Better Health has multiple options for obtaining the information you need to maximize every patient visit, including our exclusive, free website.
The prior-authorization process is now quick and easy with our secure online service. You can look up authorizations online, at your convenience. Aetna Better Health prides itself on the electronic data interface (EDI) tools we have available for our providers and we can boast one of the most multi-functional payer websites available to providers in the healthcare industry. For more information about, please visit the Provider Portal section of this website (Select here to visit the Provider Portal).
For scheduled ambulatory surgery, call our Preauthorization Department at 1-800-279-1878, at least 72 hours prior to the surgery.
For ARTS service authorization forms, please visit our provider document library and select "Provider Forms."
Inquiries related to inpatient authorizations, concurrent reviews, discharge planning, case management, and prior authorizations should be directed to our Health Services Department at 1-800-279-1878, available 24 hours a day/seven days a week. For after-hours or weekend inquiries, please choose the Prior Authorization prompt to leave a voicemail, and an on-call authorization representative will return your call.
Participating providers can now check for codes that require prior authorization via our Online Prior Authorization Search Tool.
Medical and behavioral health management criteria and practice guidelines are disseminated to all affected providers upon request and, upon request, to members and potential members. A free copy of individual guidelines pertaining to a specific case is available for review upon request by phone at 1-800-279-1878 (Medallion and FAMIS) or 1-855-652-8249 (CCC Plus).