Utilization Management Program and Precertification

Precertification is required for many services, including the following outpatient hospital benefits, physician benefits and other covered services. This list will be updated no more than twice a calendar year. You should check this list prior to obtaining any outpatient hospital service, physician services and other covered services. Group-specific policies and benefits will supersede these requirements when applicable. For the next step in obtaining a precertification, please call Customer Service at the number on the back of your member ID card to be directed to the appropriate number to call for precertification or for group specific policies and benefits.