Utilization Management Program and Precertification

Precertification is required for many services, including the following outpatient hospital benefits, physician benefits and other covered services. Below is the list of specific services in these categories that require precertification. This list will be updated no more than twice a calendar year. You should check this list prior to obtaining any outpatient hospital services, physician services and other covered services. For the next step in obtaining a precertification, please call Customer Service at the number on the back of your member ID card.