Aetna Medical Predetermination

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Precertification – Health Care Professionals | Aetna

https://www.aetna.com/health-care-professionals/precertification.html

Precertification occurs before inpatient admissions and select ambulatory procedures and services. Precertification applies to: Procedures and services on the Aetna Participating Provider Precertification List. Procedures and services on the Aetna Behavioral Health …

Health Insurance Forms for Individuals & Families - Aetna

https://www.aetna.com/individuals-families/using-your-aetna-benefits/find-form.html

Aetna has reached these conclusions based upon a review of currently available clinical information (including clinical outcome studies in the peer-reviewed published medical …

Precertification & Predetermination Guidelines | Aetna …

https://www.aetnadental.com/professionals/claim-submission-guidelines/precertification-predetermination-guidelines.html

For the Aetna Dental Preferred Provider Organization (PPO), Participating Dental Network (PDN), Affordable Health Choices, Exclusive Provider Plan (EPP), Aetna Dental …

Procedures, programs and drugs that require …

https://www.aetna.com/content/dam/aetna/pdfs/health-care-professionals/2021-precert-list.pdf

For the following services, providers call 1-866-752-7021 for precertification and fax applicable request forms to 1-888-267-3277, with the following exceptions: …

Aetna Predetermination Form 2012-2023 - signNow

https://www.signnow.com/fill-and-sign-pdf-form/10153-aetna-predetermination-form

Get aetna pre determination signed right from your smartphone using these six tips: Type signnow.com in your phone’s browser and log in to your account. If you don’t have an account yet, register. Search for the …

Health Insurance Plans | Aetna

https://www.aetna.com/document-library/healthcare-professionals/documents-forms/or-medical-exception-prior-authorization-form.pdf

Health Insurance Plans | Aetna

Difference Between Predetermination and Prior Authorization

https://www.outsourcestrategies.com/blog/predetermination-vs-prior-authorization/

A predetermination is a formal review of a patient’s requested medical care compared to their insurance’s medical and reimbursement policies (MGMA). …