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Anthem Radiology Services Recertification Alpha Prefix List (IN, KY, OH, MO, WI)rev. 4/1/08Precertification for outpatient diagnostic imaging services will be required for members with the following

How to fill out pre-certification for outpatient diagnostic

How to fill out pre-certification for outpatient diagnostic

1. To fill out the pre-certification for outpatient diagnostic, follow these steps:
2. Gather all necessary information such as patient's personal details, insurance information, and medical history.
3. Contact the insurance company or third-party administrator to obtain the pre-certification form and any specific guidelines or requirements.
4. Fill out the pre-certification form accurately and completely. Provide details about the outpatient diagnostic procedure being requested, including its purpose, medical codes, and any supporting documentation.
5. Attach any relevant medical records, test results, or physician notes that may support the need for the outpatient diagnostic procedure.
6. Review the completed form for any errors or missing information, and make sure all necessary signatures are obtained.
7. Submit the pre-certification form along with the supporting documents to the insurance company or third-party administrator according to their preferred method (mail, fax, online portal, etc.).
8. Keep a copy of the completed form and supporting documents for your records.
9. Follow up with the insurance company or third-party administrator to ensure the pre-certification request is processed in a timely manner and to address any additional requirements or questions they may have.

Who needs pre-certification for outpatient diagnostic?

1. Pre-certification for outpatient diagnostic is typically required by individuals who have health insurance coverage, such as private health insurance or employer-sponsored plans.
2. The need for pre-certification may vary depending on the specific insurance plan and policy. It is recommended to consult the insurance company or the policy documentation to determine if pre-certification is required for outpatient diagnostic procedures.
3. Patients, healthcare providers, or facilities performing the outpatient diagnostic procedures may be responsible for obtaining pre-certification depending on the insurance agreements and policies.
4. If a patient fails to obtain pre-certification when required, they may be subject to higher out-of-pocket costs or denial of coverage for the outpatient diagnostic procedure.

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What is pre-certification for outpatient diagnostic?

Pre-certification for outpatient diagnostic is a process where a patient's insurance company must be contacted and approval obtained before a diagnostic test or procedure can be performed.

Who is required to file pre-certification for outpatient diagnostic?

Healthcare providers or facilities that will be performing the outpatient diagnostic test or procedure are required to file pre-certification with the patient's insurance company.

How to fill out pre-certification for outpatient diagnostic?

Pre-certification forms can typically be filled out online or by contacting the insurance company directly. The provider will need to provide information about the patient, the test or procedure being requested, and any relevant medical history.

What is the purpose of pre-certification for outpatient diagnostic?

The purpose of pre-certification is to ensure that the test or procedure is medically necessary and that the insurance company will cover the costs. It also helps to avoid unnecessary tests or procedures.

What information must be reported on pre-certification for outpatient diagnostic?

The pre-certification form will typically require information such as the patient's name and insurance information, the provider's name and contact details, the test or procedure being requested, and any relevant medical history or diagnosis codes.