Precertification Requests

Precertification Process

Please note that precertification vendors and requirements vary by plan.
 

1. Determine Precertification Requirements. Prior to submitting a precertification request, please verify precertification requirements and where to send your request. You can do this by:

• • Calling the Provider Services or Precertification phone number listed on your patient’s member ID card. Refer to the ID card examples to the right.
  • or Visiting Access Patient Benefits, open the patient's Summary Plan Description, and navigate to the Schedule of Benefits for precertification information.

Note: if you have verified that HPI AchieveHealth provides precertification services, you may reference the Precertification List in the drop-down below.

2. Submit a Request. Submit a precertification request to the appropriate Utilization Management vendor from the options listed below.

For HIPAA verification, please be sure to provide the correct spelling and date of birth for the member prior to submitting your request.