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Prior authorization (PA)
Aetna Better Health® of Kentucky requires PA for some outpatient care, as well as for planned hospital admissions. PA is not needed for emergency care. Behavioral health providers can ask for PA 24 hours a day, 7 days a week. A current list of the services that require authorization is available on ProPAT, our online prior authorization search tool.
Tips for requesting authorization
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Tips for requesting authorization
A request for PA doesn’t count as a payment. Unauthorized services won’t be reimbursed. You can make requesting PA easier by:
Registering for the Provider Portal if you haven’t already
Verifying member eligibility prior to providing services
Completing the appropriate PA form for all physical or behavioral health requests
Attaching supporting documentation when submitting
How to request PA
Here are the ways you can ask for PA:
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By phone
You can call us Monday through Friday, from 8 AM to 6 PM ET, at 1-888-725-4969 (TTY: 711) for physical health PA. You can call us at 1-888-470-0550 (TTY: 711) for physical health or inpatient concurrent review requests. Or you can call us at 1-855-300-5528 (TTY: 711), 24 hours a day, 7 days a week to request PA for behavioral health inpatient services.
By fax
You can download the appropriate PA form. Then, send your:
Physical health PA requests to 1-855-454-5579
Physical health or inpatient concurrent review requests to 1-855-454-5043
Behavioral health PA requests to 1-855-301-1564
- Behavioral health psychological and neuropsychological testing requests to 1-844-885-0699
- Physical health retro reviews to 1-855-336-6054
If you’re requesting PA for Supporting Kentucky Youth (SKY) members, just download the appropriate PA form. Then, send your:
Physical health PA request for a SKY member to 1-833-689-1422
Physical health concurrent review request for a SKY member to 1-833-689-1423
Behavioral health outpatient request for a SKY member to 1-833-689-1424
Behavioral health and testing PA request for SKY members to 1-844-885-0699