Pre-certification Services

Receiving medical care in the hospital can be an urgent and confusing time for patients. Before the need presents itself, remember that your plan offers safeguards during these important times.

BEST Life's health 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.

Pre-certification is not required for emergency room services.

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, ask questions about the
Pre-certification program, and to request 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 ID card.