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UnitedHealthcare Oxford
Administrative PolicyPRECERTIFICATION EXEMPTIONS
FOR OUTPATIENT SERVICES
Policy Number: ADMINISTRATIVE 204.31 T0
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What is precertification exemptions?
Precertification exemptions are a form of exemption from the requirement to obtain precertification before receiving certain medical services or procedures. These exemptions allow individuals to bypass the precertification process and receive the necessary medical care without delay.
Who is required to file precertification exemptions?
Not everyone is required to file precertification exemptions. Only individuals who meet specific criteria, such as having a certain medical condition or being eligible for a certain program, are required to file for these exemptions. This requirement varies depending on the specific precertification guidelines and regulations in place.
How to fill out precertification exemptions?
Filling out precertification exemptions typically involves completing a specific form or application provided by the relevant healthcare provider or insurance company. This form generally requires individuals to provide information about their medical condition, previous treatments or procedures, and any other relevant details that support their request for exemption. It is important to carefully review and follow the instructions provided with the form to ensure accurate and complete submission.
What is the purpose of precertification exemptions?
The purpose of precertification exemptions is to provide a streamlined process for individuals who require immediate or urgent medical care that may otherwise be delayed or denied by the precertification requirement. These exemptions allow individuals to receive necessary medical services without the need for prior authorization, ensuring timely access to care.
What information must be reported on precertification exemptions?
The specific information required to be reported on precertification exemptions may vary depending on the healthcare provider or insurance company. Generally, individuals will be required to provide information about their medical condition, previous treatments or procedures, supporting medical documentation, and any other relevant details that demonstrate the need for exemption from precertification. It is important to carefully review the instructions provided with the specific precertification exemption form to ensure accurate and complete reporting.
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