In the past, FCHP always required preauthorization for elective same-day surgery. Has the procedure changed?
Fallon Community Health Plan has implemented changes in the referral process, including elective hospital/facility same-day surgery and ambulatory procedures. For all products, it is the responsibility of the facility to notify the plan of all elective hospital/facility same-day surgery and ambulatory procedures that are on the list identified in the Provider Manual. In addition, the services identified on the list in the Provider Manual also require plan preauthorization. For Fallon Preferred Care members, same-day surgery requires precertification. Private Healthcare Systems (PHCS) handles precertification for the Fallon Preferred Care product and can be reached at 1-866-416-6489.
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