Aetna GR-68744 2013 free printable template

Viscosupplementation Injectable Medication Recertification Request (All fields must be completed and legible for recertification review) Please indicate: Start of treatment: Start date Recertification

How to fill out Aetna GR-68744

How to fill out Aetna GR-68744

1. Begin by gathering all necessary personal information, including name, address, and contact details.
2. Locate and write down your Aetna member ID number on the form.
3. Fill in the details of the healthcare provider or facility that will be billing Aetna.
4. Provide the dates of service for which you are submitting the claim.
5. Complete any sections regarding the specific services received, including codes if applicable.
6. Review the form for accuracy and completeness before submission.
7. Submit the completed form to the appropriate Aetna claims department either via mail or electronically.

Who needs Aetna GR-68744?

1. Individuals who have received healthcare services covered under Aetna insurance.
2. Healthcare providers submitting claims on behalf of their patients.
3. Members who need to document and ensure their claims are reimbursed by Aetna.

People Also Ask about

Is viscosupplementation covered by insurance?

Viscosupplementation of joints other than the knee(s) will be considered not reasonable and necessary and will not be subject to coverage. Imaging procedures performed routinely for the purpose of visualization of the knee to provide guidance for needle placement will not be covered.

Does Aetna cover 20611?

Yes, Aetna's CPB for this states that ultrasound-guided injection is not covered since they consider it experimental.

Does Aetna cover gel injections in the knee?

Aetna considers intra-articular glucocorticoid injections medically necessary for the treatment of knee OA.

What are the brands of Viscosupplementation?

Brand names of viscosupplementation solutions include Hylagan, Orthovisc, Euflexxa, Supartz, and Synvisc – all of which we use at Peak Health and Wellness.

Is Aetna a medical policy on Viscosupplementation?

Aetna considers viscosupplementation experimental and investigational for the following indications (not an all-inclusive list) because the effectiveness of viscosupplementation for these indications has not been established: Chondromalacia patellae. Facet joint arthropathy.

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What is Aetna GR-68744?

Aetna GR-68744 is a specific group health insurance policy form used by Aetna to provide benefits to members.

Who is required to file Aetna GR-68744?

Employers and plan sponsors offering Aetna's group health insurance must file Aetna GR-68744 to ensure compliance with relevant regulations.

How to fill out Aetna GR-68744?

To fill out Aetna GR-68744, follow the instructions provided on the form, ensuring to provide accurate member information, coverage details, and any required signatures.

What is the purpose of Aetna GR-68744?

The purpose of Aetna GR-68744 is to document and report the specifics of group health insurance plans, including coverage details and member eligibility.

What information must be reported on Aetna GR-68744?

The information that must be reported on Aetna GR-68744 includes member names, coverage types, effective dates, and any relevant health benefit details.