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Precertification

Question tag: Precertification 42 Questions

0 Votes 1 Ans

What is Precertification?

Precertification

0 Votes 1 Ans

What is precertification approval?

Approval Precertification

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The drug my doctor prescribed requires precertification, step-therapy or has quantity limits. How can I get an exception if necessary?

doctor drug exception limits necessary Precertification prescribed quantity requires step-therapy

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What is the difference in a predetermination, a precertification and a referral?

Precertification predetermination referral

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Can I pay cash and submit a claim for reimbursement for a drug requiring precertification?

cash claim drug pay Precertification Reimbursement requiring submit

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What is the criteria for determining coverage for those drugs that require precertification or step-therapy?

coverage criteria determining drugs Precertification require step-therapy

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What are the precertification requirements?

Precertification requirements

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Who do I contact to obtain a precertification (or preauthorization) for hospital admissions, services at an outpatient facility or ambulatory surgery center?

admissions ambulatory contact facility hospital obtain outpatient preauthorization Precertification Services

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Do outpatient procedures require precertification?

outpatient Precertification procedures require

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What is automated precertification?

Automated Precertification

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Can I enter multiple cases (authorization requests) within one precertification session?

Authorization cases enter Precertification requests session

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What is precertification or prenotification, and when is it needed?

needed Precertification prenotification

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What is preadmission notification (sometimes referred to as precertification or prenotification) and when is it needed?

needed NOTIFICATION preadmission Precertification prenotification referred

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Does my office need to complete or obtain a referral, preauthorization or precertification for healthcare services?

COMPLETE Healthcare obtain Office preauthorization Precertification referral Services

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How can I support the Aetna preferred drug list and the precertification and step-therapy programs?

Aetna drug list Precertification Programs step-therapy support

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If I have a string of admissions to do with Humana, do I have to input the facility I.D. and my phone number with each admission in the precertification option?

admission admissions facility Humana input phone Precertification String

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Occasionally, the hospital list doesn’t present our facility name when I enter the facility tax I.D. What should I do in the precertification option?

doesn’t enter facility hospital list Precertification PRESENT tax

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Can I still check authorization status with the precertification option?

Authorization option Precertification Status

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Will NJ DIRECT use CareCore National, LLC (CCN) for precertification of all advanced radiological procedures?

advanced carecore CCN LLC National NJ Precertification procedures radiological

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Medical Management What is precertification for inpatient hospital care?

hospital inpatient Management medical Precertification