Precertification is the process of requesting authorization for services before receiving them.
Your health plan decides if precertification for services is required. You can check your schedule of benefits to see what services require it. You can also contact your health plan to see if precertification is required for the service you need. Check the back of your insurance card for the contact phone number.
When you receive services in a facility or hospital setting, the facility staff should call to get precertification for you.
There may be a penalty. Check your schedule of benefits to find out if your plan has a penalty.
CBA accepts precertification requests via the phone and fax.
We will need this information to process your request:
When you choose to see an in-network provider, you will pay a lower copayment or coinsurance. In-network providers will also request precertification for additional visits, when needed. Out-of-network providers are not required to perform this service for you.
Out-of-network providers are also not required to file claims on your behalf. They may ask you to pay for the visit in full and then submit the claim for reimbursement yourself. In-network providers will always file the claim for you and will accept your copayment or coinsurance as payment in full.