Prior authorization

Participating providers can now check for codes that require prior authorization via our Online Prior Authorization Search Tool.

Aetna Better Health of Louisiana requires prior authorization for select, acute outpatient services and planned hospital admissions. Prior authorization is not required for emergency services. A current list of the services that require authorization is available via the provider secure web portal. Also to request an authorization or check on the status of an authorization is also available on the portal.

If you have questions about what is covered, consult your provider manual, the provider authorization list or call 1-855-242-0802.

Tips for requesting authorizations:

  • ALWAYS verify member eligibility prior to providing services
  • Complete the authorization form for all medical and behavioral health requests
  • Attach supporting documentation when submitting

Remember, a request for prior authorization is not a guarantee of payment. Unauthorized services will not be reimbursed.

Areas for Prior Authorization

  • Behavioral Health
    We have created a dedicated fax line for your behavioral health needs. If you are a behavioral health provider, you may FAX your behavioral health prior authorization requests, assessments, and LOCUS summaries to us at 1-844-634-1109.
  • Home and Community Based Services
    Aetna Better Health of Louisiana will require prior authorization for CPST, PSR, FFT, and Homebuilders services beginning on 01/01/2018. To obtain authorization, please submit the ABHLA prior authorization form along with the intake assessment, CALOCUS/LOCUS, treatment plan, and other pertinent clinical documentation via fax to 1-844-634-1109. Authorization will be required for new and existing services. We will allow a 60 day transition period for these requests.
    We also require that the member choice form be submitted for all members receiving MHR services. For existing members, please submit the form immediately; for new members please submit the form with your prior authorization request. Forms can be faxed to 1-844-634-1109
  • Physical Health
    You can also FAX your physical health authorization request to 1-844-227-9205.
  • Non-Emergency Ambulance Transportation
    Prior Authorization is required for our members who require non-emergency ambulance transportation.
  • Updated Pediatric Day Health Care Prior Authorization Checklist