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 via the provider secure web portal. If you have questions about what is covered, consult your provider manual or call 1-855-772-9076.

Changes to Prior Authorizations

Tips for requesting authorizations:

  • ALWAYS verify member eligibility prior to providing services
  • Complete the authorization form for all medical requests
  • Attach supporting documentation when submitting

Remember, a request for prior authorization is not a guarantee of payment. Unauthorized services will not be reimbursed.