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What if ENCOMPASS is not contacted for medical review (precertification) when they should be?

April 26, 2017contacted encompass medical Precertification review

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What if ENCOMPASS is not contacted for medical review (precertification) when they should be?

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It is the responsibility of the member/patient to confirm ENCOMPASS has been contacted. Your benefits may be reduced if your health plan’s guidelines for medical review (precertification) are not followed. All claims are subject to review for eligibility, medical necessity and appropriateness.