Meritain Prior Authorization List (2024)

1. For providers - Meritain Health provider portal

  • Log in to your Meritain Health provider portal to access patient eligibility, claims information, forms and more.

2. What is Precertification and Why Do I Need It? - Meritain Health

  • Sep 9, 2021 · Precertification is an important process that helps ensure your very best health outcomes, while also helping you save on the cost of your care.

  • Wondering what is precertification? To help make sure you're getting the right care, for the right length of time in the right setting.

What is Precertification and Why Do I Need It? - Meritain Health

3. [PDF] Precertification

  • Meritain Health's Medical Management program is designed to ensure you and your eligible dependents receive the right healthcare while avoiding unnecessary ...

4. Online Certification Process

  • **Please select one of the options at the left to proceed with your request. PLEASE NOTE: The Precertification Request form is for provider use only.

  • Welcome to the Meritain Health benefits program.

5. Precertification Lists - Aetna

  • See our precertification lists or utilize our CPT code lookup to see whether a procedure or service requires prior approval. Discover the Aetna difference.

6. [PDF] Instructions for Submitting Requests for Predeterminations

  • 1. Always verify eligibility and benefits first. 2. You must also complete any other pre-service requirements, such as preauthorization, if applicable and ...

7. Provider services - Meritain Health

8. [PDF] Instructions for Submitting Requests for Predeterminations

  • Missing: list | Show results with:list

9. Resources for Members - Meritain Health insurance and provider search

  • Convenient access to information and support via our online member portal, Meritain Health app, printed and digital resources, and customer service.

  • You can find more information about your Meritain Health insurance, get support from our service specialists, and more when you log in.

10. [PDF] Precertification

  • It's easy to precertify. Your provider will often handle your precertification, but as an active participant in your health care, you.

11. [PDF] Participating provider precertification list for Aetna

  • This document is a quick guide for your office to use for precertification with patients enrolled in Aetna health plans. This process is also known as prior ...

12. Meritain Health Authorization Form - Fill Online, Printable, Fillable, Blank ...

  • The Meritain Health authorization form is a document used to obtain authorization for specific medical services or procedures.

  • We use cookies to improve security, personalize the user experience, enhance our marketing activities (including cooperating with our marketing partners) and for other business use. Click here to read our Cookie Policy. By clicking “Accept“ you agree to the use of cookies. ... Read moreRead less

13. [PDF] January 2017 Formulary List - Meritain Health

  • Some drugs may require Prior Authorization (PA). There are notations included in the lists indicating whether Prior Authorization is required or not required, ...

14. Member Services - Meritain Health

  • Need to contact Meritain Health Member Services or find out more about your health care benefits coverage? Contact number and information.

15. Meritain Med Necessity: Edit & Share | airSlate SignNow

  • People also ask meritain health medication prior authorization form. Here is a list of the most common customer questions. If you can't find an answer to your ...

  • Meritain Health Prior Authorization. Get your fillable template and complete it online using the instructions provided. Create professional documents with airSlate SignNow.

Meritain Med Necessity: Edit & Share | airSlate SignNow

16. Provider Center - Polk HealthCare Plan

  • Meritain is the third-party ... Precertification. The following items require precertification and must be authorized prior to service delivery: ...

  • Do you need to find a provider center in Polk County, Florida? Polk Healthcare Plan Providers can be found HERE.

17. [PDF] Meritain Health® Member Website User Guide

  • Missing: prior | Show results with:prior

18. Meritain Med Necessity 2019-2024 Form - Fill Out and Sign ... - SignNow

  • Let's quickly go through them so that you can be certain that your meritain health prior authorization form remains protected as you fill it out. ... list and get ...

  • Meritain Medical Necessity Com. Check out how easy it is to complete and eSign documents online using fillable templates and a powerful editor. Get everything done in minutes.

Meritain Med Necessity 2019-2024 Form - Fill Out and Sign ... - SignNow

19. [PDF] Welcome to Meritain Health Pharmacy Solutions

  • This program is designed to effectively manage specialty medications by implementing a thorough prior authorization process. ... on the list comply with the ...

20. Quantum Health

  • Quantum Health offers a uniquely powerful solution to drive healthcare navigation benefits performance while blending technology, cost savings, utilization, ...

  • Quantum Health offers a uniquely powerful solution to drive healthcare navigation benefits performance while blending technology, cost savings, utilization, and member satisfaction. NEW

Quantum Health

21. [PDF] Meritain Health Employer Website User Guide

  • Narrow your search by using claim type, claim status or, date of service or click the Apply button for a list of claims. ... Authorization Form and submit it to a ...

22. Medical Insurance - Benefits - Dickinson College

  • ... prior authorization or step therapy. Please note the excluded medications list contained in the formulary. If you are currently prescribed one of the ...

  • Details and links for medical, dental, and vision insurance information

23. Prescription drugs - PayPal Benefits

  • Breadcrumb · What you need to know · What's a formulary? · What you pay under the Meritain Health medical plans · How to submit a request for prior authorization.

  • Your prescription drug benefits depend on the medical plan you choose. The Kaiser HMO plan manages its own prescription drug benefits, while CVS Caremark provides prescription drug benefits for participants in the Meritain Health plans.

Meritain Prior Authorization List (2024)

FAQs

Are Aetna and Meritain the same? ›

Meritain Health is a popular insurance provider and is a subsidiary of its parent company, Aetna.

What is the phone number for Meritain precert? ›

Just call our Meritain Health Customer Service team at 1.800. 925.2272. If you have any questions about precertification, just call our Meritain Health Medical Management team at 1.800. 242.1199.

How to look up Meritain claims? ›

On your Claims Summary page, you can enter identifying information to search for specific claims. Simply enter the information in the appropriate boxes. You can search for claims based on claim type, claim status, provider name, claim number or dates of service. Then click the Apply button.

Does Aetna require prior authorization for MRI? ›

So, your doctor would need to send us a prior authorization request. Our clinical team will review if the MRI is medically necessary or if other treatment options may be better.

Who is Meritain associated with? ›

Subsidiary of Aetna® and CVS Health®

Access to over 1.6 million providers nationwide, unmatched network discounts and one of the largest pharmacies.

What network does Meritain use? ›

Over 90 percent of our plan sponsors choose to offer the Aetna Choice®​ POS II network, a national network with carrier-level discounts. If you start here, you'll gain access to 1.6 million health care providers nationwide, including over 350,000 behavioral health providers.

What type of plan is Meritain Health? ›

The Meritain Consumer Directed Health Plan (CDHP) with Health Savings Account (HSA) is a high-deductible health plan administered by Meritain Health. All care, including prescriptions, is subject to the deductible and coinsurance — except for preventive care and prescriptions used to manage certain medical conditions.

How do I file a claim on Meritain? ›

Log in to your Meritain Health member portal account and click Submit a Claim. Select the patient the claim is for and choose the claim type of Lifestyle Education Reimbursem*nt from the drop-down menu. Step 2: Complete the online form with the applicable information.

How long does Meritain Health claims take to process? ›

Prompt claims payment

In 2020, we turned around 95.6 percent of claims within 10 business days. Our payment, financial and procedural accuracy is above 99 percent.

Why would Aetna deny an MRI? ›

While it is unlikely that your insurer would deny your claim for an MRI scan by saying the procedure is experimental, it may claim the scan is “not medically necessary.” The insurance company may require your physician to first perform x-rays and a CT scan to determine the cause of your medical issue because those ...

How long does it take for prior authorization? ›

Taking into consideration the complexity of a prior authorization request, the prior authorization process selected by a healthcare provider, requirements set out in individual health plans, and any subsequent appeals process, a prior authorization (PA) can take anywhere from same day to over a month to process.

How to speed up prior authorization for medication? ›

How To Speed Up The Prior Authorization Process: Important Tips and Reminders
  1. Provide correct and complete patient information. ...
  2. Keep a master list of procedures that require authorizations. ...
  3. Document causes of Prior Authorization rejection. ...
  4. Subscribe to payor newsletters. ...
  5. Follow evolving industry requirements.

Is there another name for Aetna insurance? ›

Remember, Aetna and Coventry are the same company, so you and your patients may see either name or logo on the communications we send to you.

Who is the parent company of Aetna? ›

Aetna® is proud to be part of the CVS Health family.

Who took over Aetna insurance? ›

2017: On December 3, 2017, CVS Health announced the acquisition of Aetna for $69 billion. Larry Merlo became chief executive of the two brands. Aetna CEO Mark Bertolini resigned and Aetna President Karen S. Lynch took over Aetna operations.

Is Aetna the same as Blue Shield? ›

Aetna and Blue Cross Blue Shield both sell Medicare Advantage plans throughout most of the United States. Aetna has more availability, with 49 states plus Washington, D.C. versus 42 for BCBS. Our research found that Aetna Medicare Advantage plans performed better on average versus BCBS Medicare plans.

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