Temporary Changes in Prior Authorizations and Admissions (updated January 24, 2022) (PDF)

CARES Act information for providers (PDF)

Yes, Aetna will review precertification requests for elective procedures. Authorizations will remain in effect until the end of the plan year. Authorization may be extended beyond the plan year, for a period of six months, if continued eligibility can be confirmed. However, at this time there are some states that have issued orders prohibiting elective procedures. Health care providers are responsible for complying with any applicable state governmental directives that prohibit elective procedures during the COVID-19 pandemic. Aetna’s precertification of a service does not eliminate any obligations or restrictions placed on health care providers by a governmental order.

To address circumstances where PCP offices are closed due to COVID-19, Aetna has relaxed the PCP rule so no referral is necessary for Medicare Advantage plans. Aetna has not changed its PCP referral requirements for commercial plans.

Every facility that conducts COVID-19 testing is considered a “laboratory” and must be certified under CLIA. To make certification easy, CMS implemented an expedited review process at the beginning of the public health emergency and released a quick-start guide that helps laboratories with the application process.

CMS Takes Action to Protect Integrity of COVID-19 Testing

To protect the health and safety of our colleagues during the COVID-19 pandemic and ensure we can support our customers and members, we’ve deployed members of our provider experience workforce remotely when appropriate. This can result in audio quality being below our normally high standards at times. We apologize for any inconvenience this might cause.

We’re focused on delivering the best service possible to our provider community. To mitigate the effects of any technical difficulties, we’ve made available additional resources to ensure you have access to the information you need. In addition to calling our contact center, providers can now also:

• Call our 24/7 automated voice system for patient information and more
• Access our online self-service web portal
  
  
  • Go to Aetna.com
  • Access the providers page
  • Look for “Online Tools” to find the best option for your needs

We remain committed to supporting you during these challenging times. Please let us know if you have any questions. Thank you for your continued support!