VO: (Whistles...) Scoop, oh Scoop. It’s time to go to work.
VO: At Aetna International we want to make sure that the procedures and services you need are delivered in a timely manner — and your claims are processed without issues.
VO: if you are inside of the US precertification is required for certain procedures. Call our customer service center to determine if the service you are requesting requires pre- certification.
If you are outside of the US a pre- certification is not required. However some providers may require a Letter of Authorization
VO: A Letter of Authorization allows Aetna to make sure you’re getting the right treatment, and then to assess that treatment before services are received or costs are incurred.
VO: Our goal is to ensure you receive medically appropriate treatments — and have an opportunity to receive a second opinion if one is recommended.
VO: Refer to your policy, or call Aetna’s Member Service Center to see if a Letter of Authorization might be required for the service, you are seeking.
Checking first can save you time and money.
VO: Here is how you submit a request for a Letter of Authorization.
And, by the way, if you are seeing an in- network provider, they may obtain Letter of Authorization from Aetna for you. Be sure you ask.
Either way, it’s easy to submit a Letter of Authorization. Here’s how you do it.
VO: After you log in to your Aetna account, click on ‘Find health care’.
VO: Follow the easy 3 steps, Search for a provider, choose the one of your preference and apply for “direct settlement” on eligible claims.
VO: The provider results screen appears.
VO: Click ‘Direct settlements’ on your chosen provider to apply for ‘Direct Settlement’
If the provider is non-participating, you will need to complete the rest of their information.
VO: Once that is complete, the ‘Member Information’ section should already be populated with your member information.
You then need to complete the ‘Patient Information’ section
VO: When patient information is completed, click “continue”.
Finally, you need to complete the ‘About the appointment” section, which includes information about the procedure, treatment or service.
VO: When the appointment information is completed, click “submit”.
VO: And that’s it. See, I told you it was a quick and easy process
VO: We know there are situations where submitting a Letter of Authorization might be difficult. Like in the case of an emergency.
If you can notify Aetna’s Member Service Center within 24 hours of an emergency it helps both of us.
VO: We can be sure the right decisions are being made on your behalf as the Letter of Authorization allows our team of doctors and nurses to act as your advocate.
And it allows us to make sure your provider will directly settle the charges with us.
VO: That protects you by ensuring that the procedure is covered. It can even lower your out-of-pocket costs at the point you’re receiving the service.
VO: Finally, it makes it easier for you to file claims, plus gives you additional reimbursement and prepayment choices.
VO: As you can see, completing the Letter of Authorization process is convenient and fast. Plus, it provides you with peace of mind that your procedure will be covered
VO: That’s it for now Scoop. Thanks again!