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877 779 5234 Form
Birth * * MEMBER INFORMATION Member ID/Medicaid ID * (MMDDYYYY) Last Name, First REQUESTING PROVIDER INFORMATION Requesting NPI * Requesting TIN * *0622* Standard Request - Determination within 10 calendar days from receipt of all necessary information. Requesting Provider Contact Name Requesting Provider Name Phone Fax SERVICING PROVIDER / FACILITY INFORMATION Same as Requesting Provider Servicing NPI * Servicing TIN * Servicing Provider Contact Name Servicing...Show details
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People also ask
What is the payer ID for Aetna Better Health Dual Plan Illinois?Please use the following Submitter ID and Provider ID numbers when submitting claims to the health plan: Submitter ID# 26337 for both CMS 1500 and UB 04 forms.
What is the phone number for Aetna Medicaid in Illinois?You can call us at 1-866-329-4701, Monday to Friday, 8:30 AM to 5:00 PM.
What are the different types of Medicaid in Illinois?The Department operates three distinct care coordination programs within the broader Illinois Medicaid Managed Care program: HealthChoice Illinois (HCI), YouthCare, and the Medicare Medicaid Alignment Initiative (MMAI).
What is the group number for Aetna Better Health of Illinois?Our Member Services phone number is 1-866-600-2139 (TTY: 711).
Does Illinois Medicaid require prior authorization?Some prescriptions and over-the-counter medicines require prior authorization for Medicaid reimbursement. Depending upon the drug, either the prescribing physician or the dispensing pharmacist may submit the request.
What is the payer ID for Aetna Better Health Illinois Medicaid?Both claims should be submitted to payer ID 68024.
What is the provider number for Aetna Better Health Illinois?Aetna Better Health® of Illinois provides the tools and support you need to deliver care. Please view our listing below, which covers forms, guidelines and helpful links. If you need more information or have a question, contact us at 1-866-329-4701 (TTY: 711).
What procedures does Medicare require prior authorization?The services most often requiring prior approval are durable medical equipment, skilled nursing facility stays, and Part B drugs. But, each Advantage plan is different. If you have an Advantage plan, contact your plan provider to determine if or when prior authorization is necessary.
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