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. 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.

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

4. [PDF] Precertification

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

5. Precertification Lists - Aetna

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. [PDF] Instructions for Submitting Requests for Predeterminations

11. 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

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.

Meritain Med Necessity: Edit & Share - airSlate SignNow

13. 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.

14. 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

15. 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.

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.

Quantum Health

17. [PDF] A Quick Look at Your Health Plan - Dickinson Center

  • one that can be easily abused, prior authorization may be required. For more information, see your. Plan Document or contact Meritain Health Pharmacy.

Meritain Prior Authorization List (2024)


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? ›

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 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. However, like any partnership, there can be pros and cons.

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 PO box 853921 for Meritain Health? ›

address: Meritain Health, P.O. Box 853921, Richardson, TX 75085-3921. CALL 911 IMMEDIATELY IF YOU ARE HAVING A MEDICAL EMERGENCY.


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