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Procedures/services on the National Precertification List (NPL)

 

Precertification occurs before inpatient admissions and select ambulatory procedures and services. Precertification applies to all:

 

  • Procedures and services on the Aetna Participating Provider Precertification List
  • Procedures and services on the Aetna Behavioral Health Precertification List
  • Procedures and services that require precertification under the terms of a member’s plan
  • Organization determinations made by a Medicare Advantage member, appointed representative or physician for a coverage decision

You should also be sure to precertify any procedures or services on the Aetna Provider Precertification List that an Aetna® member receives during an inpatient confinement.

Refer to Aetna.com for more information.