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. 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.

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. [PDF] Precertification

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

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

  • obtain authorization from the Plan for ... Prior to effective date. ... The Plan Sponsor will maintain a list of those persons and that list is incorporated into ...

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

7. Anthem Blue Cross Blue Shield: Health Insurance, Medicare & More

  • Official Site of Anthem Blue Cross Blue Shield, a trusted health insurance plan provider. Shop plans for Medicare, Medical, Dental, Vision & Employers.

Anthem Blue Cross Blue Shield: Health Insurance, Medicare & More

8. [PDF] Welcome to Meritain Health Pharmacy Solutions

  • This program is designed to effectively manage specialty medications by implementing a thorough prior authorization process. This process takes into ...

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!

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

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

10. Insurance Plans | University of Michigan Health

  • Many insurance plans require referrals and/or authorizations in order for services to be covered. A referral is permission from your primary care physician and ...

  • Michigan Medicine participates with most health insurance plans. We recommend you check with your insurance company to confirm benefit coverage prior to scheduling an appointment. For billing and insurance questions, please contact Patient Customer Services at: 855-855-0863 or 734- 615-0863, Monday through Friday 8 a.m. – 4 p.m.

11. [PDF] A Quick Look at Your Health Plan - Dickinson Center, Inc.

  • one that can be easily abused, prior authorization may be required. For more information, see your. Plan Document or contact Meritain Health Pharmacy.

12. Health Insurance Plans | Stanford Health Care

  • ... prior to being scheduled for a New Patient Visit. What if I don't have ... – Fri., 8 a.m. – 5 p.m.. Insurance Pre-Authorization. Find out if your insurance ...

  • Learn more about the types of insurance Stanford Health Care accepts, including insurance plans through Covered California, Medicare and employer-sponsored insurance plans.

Health Insurance Plans | Stanford Health Care

13. Quantum Health

  • Fortune Selects Quantum Health to 2023 Best Workplaces in Health Care™ ListEarning a spot on the list means that Quantum Health is one of the best companies ...

  • Quantum Health offers a uniquely powerful solution to drive healthcare navigation benefits performance while blending technology, cost savings, utilization, and member satisfaction.

Quantum Health

14. [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 ...

15. CVS Caremark | PBM & Mail Order Pharmacy | Sign In

  • Sign in or register to see if your Rx requires prior authorization. ... Sign in or register to see the medications covered by your plan. Covered drug list.

  • CVS Caremark is a pharmacy benefit manager dedicated to helping each of our members on a path to better health by getting them the prescriptions they need when they need them.

CVS Caremark | PBM & Mail Order Pharmacy | Sign In
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.

What is the phone number for Meritain prior authorization? ›

Just call our Meritain Health Customer Service team at 1.800. 925.2272. If you have any questions about precertification, just call our Meritain Health Medical Management team at 1.800. 242.1199.

What is the timely filing limit for Meritain? ›

With respect to an Employee or Dependent at the time of the Initial Enrollment Period, You must submit an Enrollment Form within 31 days beginning on the initial date of Your eligibility.

How do I check the status of my Meritain Health claim? ›

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.

Does Aetna Meritain require referrals? ›

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. Preventive care/screening/ immunization No Charge Not Covered You may have to pay for services that aren't preventive.

Who is Meritain owned by? ›

With 40 years of excellence as a third party health care benefits administrator and a proud subsidiary of Aetna® and Fortune 4 company CVS Health®, Meritain Health® delivers customized, cost-effective and convenient solutions.

How do I submit a prior authorization on availity? ›

How to access and use Availity Authorizations:
  1. Log in to Availity.
  2. Select Patient Registration menu option, choose Authorizations & Referrals, then Authorizations*
  3. Select Payer BCBSOK, then choose your organization.
  4. Select a Request Type and start request.
  5. Review and submit your request.

What is prior authorization from insurance? ›

A decision by your health insurer or plan that a health care service, treatment plan, prescription drug or durable medical equipment is medically necessary. Sometimes called prior authorization, prior approval or precertification.

What kind of insurance is Meritain? ›

Meritain Health provides coverage for addiction and mental health treatment to help people recover from substance abuse and co-occurring disorders.

How do I submit a claim to 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.

What is the payer ID for Meritain Health? ›

Meritain Health/North American Administrators41124Formerly Meritain/North American Administrators Payer ID 64157.
Mesa County Colorado41556
Mesa County Valley School District 5141556
Metcare Health Plans61101
Methodist First Choice23550
46 more rows

What network does Meritain use? ›

Solutions from Meritain Health®

Our network options through Aetna® let you access over 1.6 million health care providers nationwide, including over 307,000 behavioral health providers.

What is the Meritain copay plan? ›

The Meritain Copay Plan gives you the flexibility to see any provider, anywhere, but you pay less when you see in-network providers. If you see an out-of-network provider, you're responsible for any billed charges that exceed customary and reasonable charges.

Is there another name for Aetna insurance? ›

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. We're always working to improve your experience. So if you have any questions or concerns, please call us.

Who is the parent company of Aetna? ›

Aetna® is proud to be part of the CVS Health family.

Who took over Aetna insurance? ›

2017: On December 3, 2017, CVS Health announced the acquisition of Aetna for $69 billion. Larry Merlo became chief executive of the two brands. Aetna CEO Mark Bertolini resigned and Aetna President Karen S.

Is Aetna the same as Blue Shield? ›

Aetna and Blue Cross Blue Shield both sell Medicare Advantage plans throughout most of the United States. Aetna has more availability, with 47 states versus 42 for BCBS. Our research found that Aetna Medicare Advantage plans performed better on average versus BCBS Medicare plans.

References

Top Articles
Latest Posts
Recommended Articles
Article information

Author: Lilliana Bartoletti

Last Updated:

Views: 6510

Rating: 4.2 / 5 (73 voted)

Reviews: 88% of readers found this page helpful

Author information

Name: Lilliana Bartoletti

Birthday: 1999-11-18

Address: 58866 Tricia Spurs, North Melvinberg, HI 91346-3774

Phone: +50616620367928

Job: Real-Estate Liaison

Hobby: Graffiti, Astronomy, Handball, Magic, Origami, Fashion, Foreign language learning

Introduction: My name is Lilliana Bartoletti, I am a adventurous, pleasant, shiny, beautiful, handsome, zealous, tasty person who loves writing and wants to share my knowledge and understanding with you.