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Prior authorization

Aetna Better Health® of California requires prior authorization for select acute outpatient services and planned hospital admissions. Prior authorization is not required for emergency services. A current list of the services that require authorization is available on ProPAT, our online prior authorization search tool.

 

Tips for requesting authorization

Tips for requesting authorization

A request for prior authorization is not a guarantee of payment. Unauthorized services will not be reimbursed. You can make requesting prior authorization easier for yourself by:

 

  • Registering for the Provider Portal if you haven’t already
  • Verifying member eligibility prior to providing services
  • Completing the prior authorization form for all medical requests
  • Attaching supporting documentation when submitting
  • Checking out these recent updates to prior authorization requirements

For more information

Consult your provider manual. Or call us at 
1-855-772-9076 (TTY: 711).

How to request prior authorization

 

Here are the ways you can request prior authorization:

Online

You can request prior authorization through our secure Provider Portal.

Phone

You can request prior authorization by calling us.

 

1-855-772-9076 (TTY: 711)

By fax

Download our prior authorization form. Then, fax it to us with any supporting documentation for a medical necessity review.

 

Sacramento: 1-866-489-7441

San Diego: 1-844-584-4450