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

  • 9 sep 2021 · Wondering what is precertification? To help make sure you're getting the right care, for the right length of time in the right setting.

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

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. 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.

5. [PDF] Precertification

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

6. [PDF] Participating provider precertification list for Aetna

7. 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. It is typically required by ...

  • 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

8. [PDF] The utilization review administrator, [<015Y>Meritain Health Medical ...

  • the Covered Person's claim without prior express written authorization by the Plan. ... The Plan Sponsor will maintain a list of those persons and that list is ...

9. [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 ...

10. [PDF] Welcome to Accolade and Meritain Health - PayPal Benefits

  • 1 jan 2023 · UHC will be providing Accolade with a listing of services that have already been prior-authorized. However, you can also provide a copy of ...

11. [PDF] Meritain Connect User Manual - Citizens Memorial Hospital

  • Updating your HIPAA Authorization Settings ... Click on User Documentation to view the list of user documents available. Click on the PDF icon to.

12. Meritain Prior Authorization Form: Complete with ease - SignNow

  • Meritain Health Prior Authorization. Check out how easy it is to ... How to create an eSignature for the meritain prior authorization list. Speed ...

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13. Meritain health prior authorization: Fill out & sign online | DocHub

  • Send meritain health prior authorization form via email, link, or fax. You can also download it, export it or print it out.

  • Edit, sign, and share meritain health reimbursement online. No need to install software, just go to DocHub, and sign up instantly and for free.

14. Provider Center - Polk HealthCare Plan

  • Meritain is the third-party administrator for claims and medical management. ... Referrals should be submitted prior to claim submission. Refer to a ...

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

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

  • Meritain Health Prior Authorization. Get your fillable template and ... Related links to meritain prior authorization list. A.Medicare Status Codes ...

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16. Prior Authorization Lookup: Home Page

  • For further predetermination research, you can use the following resources in the AZ Blue secure provider portal: eligibility and benefits inquiry (includes ...

  • Find out if prior authorization is required by entering the member’s group number (from ID card) and procedure code.

17. Meritain health prior authorization form pdf: Fill out & sign online

  • Select the right Meritain Health Inc.Travel Authorization Form - wiki bssd version from the list and start editing it straight away! Versions, Form ...

  • Edit, sign, and share Meritain Health Inc.Travel Authorization Form - wiki bssd online. No need to install software, just go to DocHub, and sign up instantly and for free.

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.

Does Meritain Health require referrals? ›

Do you need a referral to see a specialist? No. You can see the specialist you choose without a referral. All copayment and coinsurance costs shown in this chart are after your deductible has been met, if a deductible applies.

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.

What does a prior authorization consist of? ›

Prior authorization—sometimes called preauthorization or precertification—is a health plan cost-control process by which physicians and other health care providers must obtain advance approval from a health plan before a specific service is delivered to the patient to qualify for payment coverage.

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.

How long does prior authorization take for Aetna? ›

How long does prior authorization take? The review typically takes about 14 days. Then, we'll update you and your doctor with a decision.

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.

What is the difference between insurance referral and authorization? ›

A referral is an order from your PCP to see a specialist or receive certain medical services from some providers. Your PCP helps make the decision about whether specialist services are necessary for you. Prior authorization is approval from the health plan before you get a service or fill a prescription.

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.

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 Reimbursement from the drop-down menu. Step 2: Complete the online form with the applicable information.

Why would a prior authorization be denied? ›

If the proposed treatment doesn't meet the threshold for being medically necessary, it won't be reimbursed by the payer. If a provider's office submits a wrong billing code, misspells a name or makes another clerical error, this can result in a denied PA request.

What are three drugs that require prior authorization? ›

Drugs That May Require Prior Authorization
Drug ClassDrugs in Class
CrysvitaCrysvita
CystadaneCystadane, betaine anhydrous
DalfampridineDalfampridine
DalirespDaliresp
241 more rows

Which procedure is most likely to need a prior authorization? ›

Services That Require Prior Authorization

Examples of services that commonly require prior authorization before being approved include: Diagnostic imaging (such as MRIs, CTs, and PET scans) Durable medical equipment (such as wheelchairs) Rehabilitation (like physical or occupational therapy)

When did Aetna buy Meritain? ›

2011: Aetna acquired Prodigy Health Group, parent of third-party administrator Meritain Health.

What company did Aetna merge with? ›

The CVS-Aetna merger was a horizontal and a vertical merger. In horizontal mergers, two competitors combine, and CVS-Aetna are significant competitors in numerous Medicare Part D geographic markets and also with respect to pharmaceutical benefit management (PBM) services.

Does Aetna have another name? ›

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.

What is the company name of Aetna? ›

Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna).

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