Posted in #aetna, Training, Updates

Aetna National Precert List: Update effective 09/01/21

Effective 09/01/2021 the following changes will take place:

  1. Drugs for the multiple myeloma indication only, will require prior authorization:
  • Velcade® (bortezomib)
  • Bortezomib (generic Velcade®)
  • Kyprolis® (carfilzomib)

2. Oral hepatitis C drugs will no longer require medical precertification. However, they may still require prior authorization through pharmacy benefit.

Submitting precertification requests:
Be sure to submit precertification requests at least two weeks in advance. To save time, request precertification online. Doing so is fast, secure and simple. You can submit most requests online through our provider portal on Availity. Or you can use the Electronic Medical Record (EMR) system portal.

Who do I contact for a precertification on a specialty drug for a commercial or Medicare member?

Then submit your request through NovoLogix®, also available on Availity®

Please use our “Search by CPT code” search function on our Precertification Lists web page to find out if the code needs precertification.

#priorauthorization , #novologix, #aetnacommercial, #aetnamedicare, #aetnanationalprecertlist

Author:

My name is Kate Patskovska, CPB. I am an Independent Medical Biller CPB (AAPC) and an owner of KR2 Medical Billing. KR2 Medical Billing is a full service Consulting/Medical Billing Business that is dedicated to educating, consulting, and overall improving the "financial health" of your medical practice.

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