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.
Prior authorization requests for commercial and Medicare Advantage members are being approved 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.
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. For more information, visit the news release issued by CMS.
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:
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!
Aetna is the brand name used for products and services provided by one or more of the Aetna group of subsidiary companies, including Aetna Life Insurance Company and its affiliates (Aetna).
This material is for information only. Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional. Information is believed to be accurate as of the production date; however, it is subject to change.
Health benefits and health insurance plans contain exclusions and limitations.
You are now being directed to the AMA site
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You are now being directed to the Give an Hour site
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You are now being directed to the CVS Pharmacy site
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You are now being directed to the CDC site
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You are now being directed to the CVS Health site
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You are now being directed to the Apple.com COVID-19 Screening Tool
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You are now being directed to the US Department of Health and Human Services site
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You are now being directed to the CVS Health COVID-19 testing site
Links to various non-Aetna sites are provided for your convenience only. Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites.
You are now being directed to
The Fight Is In Us site
Links to various non-Aetna sites are provided for your convenience only. Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites.
Links to various non-Aetna sites are provided for your convenience only. Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites.
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