Question:
Do anyone know what precertification is?
I am so disgusted with my insurance co. as you all know I wrote in on friday happy as a lark well I got a call from my doctors nurse asking me questions for some reason I got curious and called my insurance co. who told me that I was not approved I was only given a precertification I guess you know how annoyed I am please tell me what it is. — TANGIE B. (posted on November 6, 2000)
November 6, 2000
Tangie, I'm sorry, the process is a royal pain alright. Precertification
is often used synonomously with "prior- authorization" and
"pre-approval". They are to be thought of as processes not
events. (Some companies make them more eventful that others) The percert.
process usually follows a criteria of proving "medical
necessity". Once the process is complete, the insurance company will
issue an approval or a denial. I hope this helps! Much love,
— Alicia B.
November 6, 2000
I heard that some insurance companies are no longer requiring pre-approval
for RNY surgery. But they will pre-certify or pre-authorize your admission
to the hospital. And as long as you meet their guidlines for Medical
Necessity they will pay for the surgery once it is completed. I am not
positive of this but it might be worth checking into! I wish you good luck!
— imano1momy
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