Ameriben Prior Authorization Form - Fill and Sign Printable Template Online (2024)

FAQs

How do I request precertification with AmeriBen? ›

You must submit an electronic precertification request on our secure provider website on NaviNet® at connect.navinet.net. Or you can choose any other website that allows precertification requests from our list at aetna.com/provider/vendor. You can also inquire electronically on previously submitted requests.

Need Help? You can reach us at the number on the back of your medical card. If you do not have access to your card, you can reach us at our general phone number 1-800-786-7930.

AmeriBen is a private Third-Party Administrator (TPA) that specializes in administering complex benefit plans for over 80 self-funded employer groups and fully insured university plans totaling over 500,000 member lives.

AmeriBen, ATTN: CoC, PO Box 7186, Boise, ID 83707.

Prior authorization—sometimes called preauthorization or precertification—is a health plan cost-control process by which physicians and other health care providers must obtain advance approval from a health plan before a specific service is delivered to the patient to qualify for payment coverage.

Our collaboration with AmeriBen¹ provides expertise in claims administration and processing. Partnered with Anthem's diverse network of local health professionals, we bring collaborative expertise to your healthcare plan.

Who acquired AmeriBen? AmeriBen was acquired by Elevance Health.

AmeriBen is a Third Party Administrator headquartered in Meridian, Idaho. AmeriBen has been in business since 1958 and began processing medical claims in 1964.

What is the difference between a TPA and a carrier? Unlike carriers, TPAs don't offer insurance or assume financial risk for members' healthcare expenses. Instead, TPAs offer administrative support for businesses with self-funded health plans. They serve as mediators between employers, members, carriers, and providers.

What are the four core values of AmeriBen? ›

We apply AmeriBen's cultural values of Integrity, Initiative, Good Judgement, and Teamwork in serving as a resource and strategic partner to our 230+ client organizations and seek to leverage our clients' own cultural values to create tailored and relevant answers.

TPA stands for Third Party Administrator and as such is defined as an organization or individual that handles the claims, processing, and reporting components of a self-funded health benefits plan.

For precertification of pharmacy-covered specialty drugs (notedwith*) when memberis enrolled in a commercialplan,call 1-855-240-0535 or fax applicable request forms to 1-877-269-9916.

For additional information, please contact the AmeriBen HR Consulting Resource Center at 888-716-4482 or via email at resourcecenter@ameriben.com.

Iec Group, Inc., doing business as AmeriBen, provides human resource consulting. The Company offers administrative services. AmeriBen operates in the United States.

Requesting authorizations on Availity* is a simple two-step process. Here's how it works: Submit your initial request on Availity using the Authorization (Precertification) Add transaction. Complete a short questionnaire, if asked, to give us more clinical information.

A decision by your health insurer or plan that a health care service, treatment plan, prescription drug or durable medical equipment is medically necessary. Sometimes called prior authorization, prior approval or precertification.

In order to determine the appropriate portal to use to submit your prior authorization, we have made it easy for you. Simply visit the EviCore's Provider's Hub page and select the health plan and solution option for your case in the training section.

Prior authorization is a requirement that a health care provider obtain approval from Medicare to provide a given service. Prior Authorization is about cost-savings, not care. Under Prior Authorization, benefits are only paid if the medical care has been pre-approved by Medicare.