Example: air traffic controller
Aetna Therapy Fax Request Fax
Found 2 free book(s)
Specialty Medication Precertification Request - Aetna
www.aetna.comPrecertification Request Aetna Precertification Notification Phone: 1-866-752-7021 FAX: 1-888-267-3277 For Medicare Advantage Part B: Phone: 1-866-503-0857 FAX: 1-844-268-7263 (All fields must be completed and legible for Precertification Review.) Please indicate: Start of treatment: Start date. Continuation of therapy: Date of last treatment
Prescription Drug Prior Authorizathion Request Form - Aetna
www.aetna.comFax this form to: 1-877-269-9916 OR Submit your request online at: www.availity.com CALIFORNIA PRESCRIPTION DRUG PRIOR AUTHORIZATION OR STEP THERAPY EXCEPTION REQUEST FORM Patient Name: ID#: Instructions: Please fill out all applicable sections on both pages completely and legibly.