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Clinical questionnaire for prior authorization requests

It’s easier than ever to request authorizations for selected procedures and submit requested clinical information on the Availity® provider portal.

What are the selected procedures?

What are the selected procedures?

  • Gastroplasty and gastric revision

  • Bone-anchored hearing aid (BAHA)
  • Cochlear implant
  • Endoscopic nasal balloon dilation
  • Functional endoscopic sinus surgery (FESS)

  • Frozen embryo transfer

  • Dorsal column stimulator
  • Laminectomy and laminotomy
  • Spinal fusion - scoliosis

  • Orthognathic

  • Hip or knee replacement
  • Hip or knee surgery to repair impingement syndrome
  • Shoulder replacement

  • Apronectomy and panniculectomy
  • Blepharoplasty and canthopexy
  • Breast reconstruction
  • Breast reduction
  • Lipectomy

  • Venous ligation

  • Discharge verification and disposition
  • Pre-implantation genetic testing

How to authorize services and submit clinical information

We’ve simplified the process. Just follow these steps.
 

Step 1: Log in to Availity to submit your initial request using the Authorization (Precertification) Add transaction.


Don’t have Availity access? Set up Availity account.
 

Step 2: Complete a short questionnaire, if asked, to give us clinical information.

That’s it! You may get an approval right away after completing the questionnaire. There’s no need to call in requests or fax medical records.

Learn more about the clinical questionnaire

Legal notices

Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna).

Health benefits and health insurance plans contain exclusions and limitations.

Also of interest: