What is a pre-certification?
FIC requires pre-approval for certain services and procedures; this is known as “pre-certification”. A provider or a patient can request pre-certification before the service or procedure is administered. A penalty may be applied to your coverage if a pre-certification is not obtained. While the provider may request the pre-certification, you are responsible for making sure your service has been approved before receiving treatment.
Related Questions
- What are the pre-certification requirements for inpatient hospital confinements, maternity or residential treatment care?
- How does NMHPA affect prior authorization or pre-certification for a hospital stay in connection with childbirth?
- If a patient refuses to sign consent to release information, is a pre-certification call still required?
