Aetna Precert Tool
Use the tool to check if you need precertification for procedures and services. See the precertification lists and medical preferred drug information for different benefit plans and effective dates. Use propat, the online pa search tool, or register for availity to submit pa requests. This guide explains how to request precertification for services, programs and prescriptions that require approval for coverage with gravie health plans. It includes cpt codes, best practices and contact information for aetna and cvs caremark.
Enter up to six codes or a cpt group and see the results for each code or group. Learn how to request coverage approval for your patients before inpatient admissions and select ambulatory procedures and services. Find out the criteria, lists and methods for precertification, notification and coverage determination. Learn how to get approval for certain medical procedures, tests and prescriptions from aetna. Find out what services require prior authorization, how to check the status and how to contact aetna for more information. Learn how to obtain prior authorization for medically necessary therapy or medications for aetna better health members. Find out which services require authorization, how to request them, and how to access the secure web portal.
