Meritain Prior Authorization List (2024)

Table of Contents
1. For providers - Meritain Health provider portal 2. Online Certification Process 3. What is Precertification and Why Do I Need It? - Meritain Health 4. Precertification Lists - Aetna 5. [PDF] Precertification 6. [PDF] Instructions for Submitting Requests for Predeterminations 7. Provider services - Meritain Health 8. [PDF] Precertification 9. [PDF] Participating provider precertification list for Aetna 10. Resources for Members - Meritain Health insurance and provider search 11. [PDF] Instructions for Submitting Requests for Predeterminations 12. Meritain Med Necessity: Edit & Share - airSlate SignNow 13. Meritain Health Authorization Form - Fill Online, Printable, Fillable, Blank ... 14. Provider Center - Polk HealthCare Plan 15. Medical Insurance | Insurance Benefits | Dickinson College 16. Quantum Health 17. [PDF] Welcome to Meritain Health Pharmacy Solutions 18. Prescription drugs - PayPal Benefits 19. [PDF] Meritain Connect User Manual - Citizens Memorial Hospital 20. [PDF] A Quick Look at Your Health Plan - Dickinson Center, Inc. 21. Member services - Meritain Health 22. Meritain health prior authorization: Fill out & sign online | DocHub 23. Accolade: Personalized Healthcare 24. Meritain Prior Authorization Form: Complete with ease 25. Utilization Management | American Health Holding 26. [PDF] Welcome to Accolade and Meritain Health - PayPal Benefits 27. [PDF] 2023 List of Covered Drugs/Formulary - Aetna Better Health 28. [PDF] How to Find an In-Network Provider | Meritain Health FAQs References

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. Online Certification Process

  • Welcome to the Meritain Health benefits program. **Please select one of the ... PLEASE NOTE: The Precertification Request form is for provider use only.

  • Welcome to the Meritain Health benefits program.

3. What is Precertification and Why Do I Need It? - Meritain Health

  • Sep 9, 2021 · Before admission to the hospital for elective or non-emergency services. · Within 48 hours (two working days) after an emergency or urgent ...

  • Wondering what is precertification? To help make sure you're getting the right care, for the right length of time in the right setting.

4. 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.

5. [PDF] Precertification

  • Meritain Health's Medical Management program is designed to ensure you and your eligible dependents receive the right healthcare while avoiding unnecessary ...

6. [PDF] Instructions for Submitting Requests for Predeterminations

  • 1. Always verify eligibility and benefits first. 2. You must also complete any other pre-service requirements, such as preauthorization, if applicable and ...

7. Provider services - Meritain Health

  • Find more information about how to contact us and learn more through our provider portal. Visit the Meritain Health Provider Services page.

8. [PDF] Precertification

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

9. [PDF] Participating provider precertification list for Aetna

10. Resources for Members - Meritain Health insurance and provider search

  • You can find more information about your Meritain Health insurance, get support from our service specialists, and more when you log in.

11. [PDF] Instructions for Submitting Requests for Predeterminations

  • Missing: list | Show results with:list

12. Meritain Med Necessity: Edit & Share - airSlate SignNow

  • Meritain Health Prior Authorization. Get your fillable template and ... Related links to meritain prior authorization list. A.Medicare Status Codes ...

  • Meritain Health Prior Authorization. Get your fillable template and complete it online using the instructions provided. Create professional documents with airSlate SignNow.

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

  • The individuals who are required to file a Meritain Health authorization form are typically plan participants or policyholders who are seeking to use certain ...

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

14. Provider Center - Polk HealthCare Plan

  • Meritain is the third-party ... Precertification. The following items require precertification and must be authorized prior to service delivery: ...

  • Do you need to find a provider center in Polk County, Florida? Polk Healthcare Plan Providers can be found HERE.

15. Medical Insurance | Insurance Benefits | Dickinson College

  • ... prior authorization or step therapy. Please note the excluded medications list contained in the formulary. If you are currently prescribed one of the ...

  • Details and links for medical, dental, and vision insurance information

16. 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 to ...

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

17. [PDF] Welcome to Meritain Health Pharmacy Solutions

  • This program is designed to effectively manage specialty medications by implementing a thorough prior authorization process. ... on the list comply with the ...

18. Prescription drugs - PayPal Benefits

  • ... Meritain Health plans. Visit CVS Caremark · What's a formulary?What you pay ... Check the Medications Requiring Prior Authorization list, and if you are ...

  • Your prescription drug benefits depend on the medical plan you choose. The Kaiser HMO plan manages its own prescription drug benefits, while CVS Caremark provides prescription drug benefits for participants in the Meritain Health plans.

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

  • Updating your HIPAA Authorization Settings ... Click on User Documentation to view the list of user documents available. Click on the PDF icon to.

20. [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.

21. Member services - Meritain Health

  • Need to contact Meritain Health Member Services or find out more about your health care benefits coverage? Contact number and information.

22. Meritain health prior authorization: Fill out & sign online | DocHub

  • Send meritain health prior authorization form via email, link, or fax. You can also download it, export it or print it out.

  • Edit, sign, and share meritain health reimbursem*nt online. No need to install software, just go to DocHub, and sign up instantly and for free.

23. Accolade: Personalized Healthcare

  • Accolade provides access to quality primary care, mental health support, and expert medical opinions all backed by a team of clinical and benefits ...

  • Accolade provides access to quality primary care, mental health support, and expert medical opinions all backed by a team of clinical and benefits specialists.

24. Meritain Prior Authorization Form: Complete with ease

  • Meritain Health Prior Authorization. Check out how easy it is to ... How to create an eSignature for the meritain prior authorization list. Speed ...

  • Meritain Health Prior Authorization. Check out how easy it is to complete and eSign documents online using fillable templates and a powerful editor. Get everything done in minutes.

25. Utilization Management | American Health Holding

  • American Health's Utilization Review service and iSuite medical management software provides our claims processors with easy access to all the precertification ...

  • How is Utilization Management different at American Health Holding?

26. [PDF] Welcome to Accolade and Meritain Health - PayPal Benefits

  • Jan 1, 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 ...

27. [PDF] 2023 List of Covered Drugs/Formulary - Aetna Better Health

  • • Decide to require or not require prior authorization (PA) or approval for a drug. (PA is permission from Aetna Better Health Premier Plan MMAI before you ...

28. [PDF] How to Find an In-Network Provider | Meritain Health

  • Whether you directly type-and-search the type of provider or select the type of physician, you will be provided with a list of providers within your network ...

Meritain Prior Authorization List (2024)

FAQs

What is the phone number for Meritain prior authorization? ›

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

Are Aetna and Meritain the same? ›

Can you pay for Rehab with Meritain Health? Meritain Health is a popular insurance provider and is a subsidiary of its parent company, Aetna. Meritain offers private policies that range from individual to family coverage as well as employer-based policies.

How do I submit claims 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 Reimbursem*nt from the drop-down menu. Step 2: Complete the online form with the applicable information.

What network does Meritain use? ›

Choose one of our Aetna networks®

As an exclusive offering, Meritain Health is the only TPA able to offer access to this network. By selecting any of our Aetna network options, you'll ensure members can find quality care and affordable options whenever they need them.

How do I submit a prior authorization on availity? ›

Requesting authorizations on Availity* is a simple two-step process. Here's how it works: Submit your initial request on Availity using the Authorization (Precertification) Add transaction. Complete a short questionnaire, if asked, to give us more clinical information.

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.

Who is Meritain associated with? ›

Subsidiary of Aetna® and CVS Health®

Access to over 1.6 million providers nationwide, unmatched network discounts and one of the largest pharmacies.

Is Aetna owned by CVS? ›

CVS Health-owned Aetna on Monday rolled out a plan design that would steer patients toward its parent company's brick-and-mortar locations — a key concern of antitrust regulators in reviewing the almost $69 billion megamerger that closed in 2019.

What did Aetna used to be called? ›

Aetna is descended from Aetna (Fire) Insurance Company of Hartford, Connecticut.

What type of plan is Meritain Health? ›

The Meritain Consumer Directed Health Plan (CDHP) with Health Savings Account (HSA) is a high-deductible health plan administered by Meritain Health. All care, including prescriptions, is subject to the deductible and coinsurance — except for preventive care and prescriptions used to manage certain medical conditions.

How do I check my Meritain claim status? ›

Just click Claims to view your claim information. The Apply button lets you view all claims. Claims with statuses of In Process, Processed or Awaifing Review will be displayed.

What is the payer ID for Meritain insurance? ›

Formerly Meritain/North American Administrators Payer ID 64157.

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.

What is PBM for Meritain Health? ›

Often called pharmacy benefit managers (PBMs), it's to construct prescription drug benefit offerings in a way that reduces wasteful spending.

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. People who have Meritain insurance plans may receive partial or full coverage for most substance abuse treatments, though coverage will vary based on the plan.

What is the fax number for BCBS of Illinois prior authorization? ›

Fax each completed Predetermination Request Form to 800-852-1360. If unable to fax, you may mail your request to BCBSIL, PO BOX 805107, Chicago, IL, 60680-3625.

What is the timely filing limit for Meritain Health? ›

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.

What is the PO box 853921 for Meritain Health? ›

address: Meritain Health, P.O. Box 853921, Richardson, TX 75085-3921.

References

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