Meritain Prior Authorization List (2024)

Table of Contents
1. For providers - Meritain Health provider portal 2. What is Precertification and Why Do I Need It? - Meritain Health 3. Precertification Lists - Aetna 4. Online Certification Process 5. [PDF] Precertification 6. [PDF] Precertification 7. [PDF] The utilization review administrator, [<015Y>Meritain Health Medical ... 8. [PDF] Medical Exception/Prior Authorization/Precertification ... 9. Meritain Health Authorization Form - Fill Online, Printable, Fillable, Blank ... 10. [PDF] Welcome to Meritain Health Pharmacy Solutions 11. [RTF] Meritain Full Benefits Document 2023 (RTF) - Offices - Vassar College 12. Prior Authorization Lookup: Home Page 13. [PDF] Welcome to Accolade and Meritain Health - PayPal Benefits 14. Meritain health prior authorization form pdf: Fill out & sign online FAQs

1. For providers - Meritain Health provider portal

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

See details ›

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.

See details ›

3. 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.

See details ›

4. Online Certification Process

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5. [PDF] Precertification

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

Free Download ›

6. [PDF] Precertification

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

Free Download ›

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

Free Download ›

8. [PDF] Medical Exception/Prior Authorization/Precertification ...

  • Please list all medications the patient has tried specific to the diagnosis and specify below: Therapeutic failure, including length of therapy for each ...

Free Download ›

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

  • Fill Meritain Health Authorization Form, Edit online. Sign, fax and printable from PC, iPad, tablet or mobile with pdfFiller ✓ Instantly. Try Now!

  • 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

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10. [PDF] Welcome to Meritain Health Pharmacy Solutions

  • ... prior authorization process. This process takes ... The drugs on the list comply with the preventive drug list ... Please email Meritain Health Pharmacy Solutions ...

Free Download ›

11. [RTF] Meritain Full Benefits Document 2023 (RTF) - Offices - Vassar College

  • ... meritain.com. SUMMARY OF MATERIAL ... List of Items and/or Services that require Precertification ... Step Therapy is a type of prior authorization. In ...

Free Download ›

12. 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.

See details ›

13. [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 ...

Free Download ›

14. 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.

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Meritain Prior Authorization List (2024)

FAQs

Why do prior authorizations get denied? ›

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. This is common for procedures like cosmetic surgery or treatments not approved by the FDA.

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How can I make my prior authorization easier? ›

16 Tips That Speed Up The Prior Authorization Process
  1. Create a master list of procedures that require authorizations.
  2. Document denial reasons.
  3. Sign up for payor newsletters.
  4. Stay informed of changing industry standards.
  5. Designate prior authorization responsibilities to the same staff member(s).

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How can I speed up my prior authorization insurance? ›

Provide correct and complete patient information.

One of the primary reasons that Prior Authorizations take so long to process is that incomplete or incorrect information is submitted to the health insurance provider. Take note that the smallest details matter.

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What happens if prior authorization is not obtained? ›

If your provider doesn't ask for prior authorization when required, the claim will be denied. The provider CANNOT bill you for the treatment if they did not get prior authorization.

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How do you fight a prior authorization denial? ›

Whether a denial is based on medical necessity or benefit limitations, patients or their authorized representatives (such as their treating physicians) can appeal to health plans to reverse adverse decisions. In most cases, patients have up to 180 days from the service denial date to file an appeal.

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How long does Aetna prior authorization take? ›

You and your provider will get a letter stating whether the service has been approved or denied. We will make a decision within 5 business days, or 72 hours for urgent care. If we deny your service, we will explain why in the letter.

Learn More ›
What are three drugs that require prior authorization? ›

Other examples of drugs that might require prior authorization from some insurers are:
  • tralokinumab-ldrm (Adbry)
  • acalabrutinib (Calquence)
  • naltrexone bupropion (Contrave)
  • methoxy polyethylene glycol-epoetin beta (Mircera)

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Why is prior authorization taking so long? ›

Delayed Access To Treatments

But even when you're confident that you need to get pre-authorization, the manual process for your practice staff takes time. And because the forms and details regularly change as well, this often leads to delays. You might be able to obtain prior authorization within 24 hours.

Find Out More ›
Who is responsible for obtaining preauthorization? ›

How do I get a prior authorization? If your health care provider is in-network, they will start the prior authorization process. If you don't use a health care provider in your plan's network, then you are responsible for obtaining the prior authorization.

Read On ›
Can a pre-authorization be declined? ›

If a guest has insufficient funds for the pre-authorization itself, then the transaction should be declined outright.

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What is the proper response to a failure to obtain preauthorization denial? ›

Explanation: The proper response to a failure to obtain preauthorization denial is to request a retrospective review. This type of review occurs after the medical service has been provided, and it involves the insurance company evaluating the claim to determine if it meets the necessary criteria for coverage.

Read On ›
Why would an insurance company deny coverage? ›

All insurance policies contain a list of things that will not be covered. The insurer will deny your claim if it finds that the type of damage you've sustained falls under a policy exclusion. Common examples of policy exclusions include intentional acts of vandalism or damage caused by storms.

Find Out More ›
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