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What is the penalty for not using the utilization review (pre certification) process?

April 26, 2017Certification penalty process review utilization

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What is the penalty for not using the utilization review (pre certification) process?

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The penalty is a $250.00 deductible for each hospital confinement or surgical procedure. Your co pay is raised to 50% of usual and customary charges. These penalties will not count towards your out of pocket maximum.