"}},{"@type":"Question","name":"Is Aetna the same as Blue Shield?","acceptedAnswer":{"@type":"Answer","text":"Aetna and Anthem are different health insurance companies. Aetna has broader availability, especially with Medicare Advantage plans. Aetna sells health insurance in 47 states. Anthem is a brand of the Blue Cross Blue Shield network."}}]}}

Meritain Prior Authorization List (2024)

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. 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.

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

3. 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.

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

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. Resources for Members - Meritain Health insurance and provider search

  • The Authorization for Release of Information form is required according to ... All About Precertification. Meritain Health. Search. Info. Shopping. Tap to ...

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

10. 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 ...

  • We use cookies to improve security, personalize the user experience, enhance our marketing activities (including cooperating with our marketing partners) and for other business use. Click here to read our Cookie Policy. By clicking “Accept“ you agree to the use of cookies. ... Read moreRead less

11. 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.

Meritain Med Necessity: Edit & Share | airSlate SignNow

12. [PDF] Instructions for Submitting Requests for Predeterminations

  • Missing: list | Show results with:list

13. Forms for health care professionals - Aetna

  • Applications and forms for health care professionals in the Aetna network and their patients can be found here. Browse through our extensive list of forms ...

  • Applications and forms for health care professionals in the Aetna network and their patients can be found here. Browse through our extensive list of forms and find the right one for your needs.

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. [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 ...

17. Quantum Health

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

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

Quantum Health
Meritain Prior Authorization List (2024)

FAQs

Are Meritain and Aetna the same? ›

Meritain Health is a popular insurance provider and is a subsidiary of its parent company, Aetna.

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 Reimbursement from the drop-down menu. Step 2: Complete the online form with the applicable information.

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 the Meritain explanation of benefits? ›

Your EOB includes information such as your name and address, dates of service, general description of services provided, claim numbers, total cost of the service, what you owe and more. Your EOB is set up in an easy-to-read format that gives a full explanation of many bill-related questions you may have.

Who is the parent company of Meritain Health? ›

Subsidiary of Aetna® and CVS Health®

What network does Meritain use? ›

Solutions from Meritain Health®

Our broad network option—Aetna Choice®​ POS II network—gives you access to a full,​ nationwide network with carrier-level discounts. ​We're the only third party administrator (TPA) able to offer this network.

How long does Meritain Health take to process? ›

Prompt claims payment

In 2020, we turned around 95.6 percent of claims within 10 business days. Our payment, financial and procedural accuracy is above 99 percent.

How do I check my Meritain claim status? ›

At meritain.com you can:

Find the status of claims. View your Explanations of Benefits (EOBs). Review your benefit plan document.

What is the Aetna timely filing limit in 2024? ›

Within 180 calendar days of the initial claim decision.

Does Meritain Health cover IVF? ›

Once you've met your Meritain plan deductible, authorized fertility services will be covered at 90%.

Is there another name for Aetna insurance? ›

Remember, Aetna and Coventry are the same company, so you and your patients may see either name or logo on the communications we send to you. We're always working to improve your experience. So if you have any questions or concerns, please call us. You can reach us at the number on your patients' ID cards.

What company did Aetna merge with? ›

The CVS-Aetna merger was a horizontal and a vertical merger. In horizontal mergers, two competitors combine, and CVS-Aetna are significant competitors in numerous Medicare Part D geographic markets and also with respect to pharmaceutical benefit management (PBM) services.

What are the subsidiaries of Aetna? ›

Is Aetna the same as Blue Shield? ›

Aetna and Anthem are different health insurance companies. Aetna has broader availability, especially with Medicare Advantage plans. Aetna sells health insurance in 47 states. Anthem is a brand of the Blue Cross Blue Shield network.

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