What information is needed when calling ENCOMPASS to begin the medical review (precertification) process?
ENCOMPASS needs the following information, most of which can be found on the patient or member’s health plan identification card: • Patient’s first and last name, address and phone number • Patient’s date of birth • Health plan name • Subscriber or insured’s plan identification number • Dates of medical service to be provided • Physician name, address and phone number • Hospital name, address and phone number (if applicable) • Type of treatment and reason for that treatment
