Medical emergencies are always urgent, and can present a confusing time for patients. Before a medical emergency presents itself, remember that your plan offers safeguards during these important times.
BEST Life's medical plans include pre-certification services, an important cost savings tool that may help your organization avoid unnecessary or excessive medical costs.
Pre-certification (also known as case management) is a process we use to make sure that your employees receive the care that is necessary and appropriate for their circumstance. Case management does not affect their freedom to choose their own physician or hospital. It is just our way of monitoring the decisions and recommendations their doctors make.
Most of the time, doctors will file a Pre-certification on a member’s behalf, but members can also call the phone number provided on the back of their ID cards to talk to a Registered Nurse and get a Pre-certification.
Pre-certification is required when a member needs medical attention that results in a(n) inpatient (hospital) admission (call within 24-48 hours of admission), outpatient surgery procedure, MRI, CAT Scan, PET Scan, nuclear imaging or transplant.
To request a Pre-certification, members can call the phone number on the back of their BEST Life medical ID card.
