Authorization Policies for Aetna Better Health, Inc

Health Provider Website: https://www.aetnabetterhealth.com/
Accepted Health Plans: Medicaid Healthy Kids

Does the diagnostic service require prior authorization?

MRI: YES*
CT Scans: YES*
PET: YES*
X-rays: YES
Polysonograms: YES**
Ultrasounds: YES
Physical Therapy: YES**
Occupational Therapy: YES**
Audio Evaluation: YES
Audio Evaluation: YES
Speech Evaluation: YES**
Feeding and Swallowing Evaluation: YES**

*Authorizations for high-end imaging (MRI, CT, PET Scans) are issued by Evicore. Please contact 1-888-693-3211 to obtain authorization.
**Aetna members must utilize the United Health Systems Sleeps Centers. Authorizations are only valid for NCH once an attempt was made at United Health Systems.
***Aetna Better Health does require pre-cert for rehab through HN1 (DADE & MONROE) or South Florida Musculoskeletal (BROWARD & PALM BEACH). Unfortunately, at this time NCH does not have a contract with neither provider for these regions.Please verify with your health plan for an in network provider.

Lab Information

Preferred Independent Lab: LabCorp or Quest Diagnostics
Laboratory testing cannot be administered without the required forms. Please bring the >LabCorp form or Quest Diagnostics form (provided by your doctor) to your appointment. Lab Hours of Operation are from 7 a.m. to 3 p.m. Monday through Friday and 7 a.m to 11 a.m. on Saturdays. Labs are closed Sundays. For additional information please call 305-666-6511 ext 1964.


Contact Us

The Authorization Unit can can contacted at 786-624-3022 as well as Managed Care at 305-669-5834 for further clarification.


Please note that some non-employed physicians and credentialed medical staff members of Nicklaus Children's Hospital may not accept all of the health plans listed above. Also note that participation in these plans is not a guarantee of payment or coverage.

This page was last updated on : 7/11/2019 11:11:57 AM.