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Precertification vendors and requirements vary by plan. Please call the Provider Services or Precertification phone number on your patient’s member ID card or visit Access Patient Benefits to determine where to send your precertification request and to review your patient's plan description for a full list of services requiring precertification.

Precertification completed by HPI AchieveHealth® CMS

Precertification forms below are only for plans using AchieveHealth CMS in New England and Halifax. Please verify the correct precertification vendor prior to submitting forms; unverified precertifications will be returned.

AchieveHealth Precertification List

Download a Precertification Request form* (unverified requests may not be processed)

*If your patient's plan requires Precertification for a service or procedure listed below, please complete the Standard Precertification Request form in addition to the applicable form below.

Precertification completed by MedWatch

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