Under the PHBP Medical Plan, what happens if the hospital does not pre-certify my admission?
It is the hospital’s responsibility to pre-certify all admissions by calling 1-877-624-6210 once you have given them the information by presenting your ID card. Remind your provider to call for pre-certification when you know that you will be admitted. If it is an emergency visit, the facility may call within 24 hours after the admission. If the hospital or surgi-center fails to call and give MagnaCare the required information, the facility will not receive payment from the Plan. The hospital/surgi-center can appeal to MagnaCare to receive payment but it must provide all of the documentation pertinent to your hospital admission. Scheduled procedures performed in a hospital should be pre-certified by the physician.
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- Under the PHBP Medical Plan, what happens if the hospital does not pre-certify my admission?
