If you need preauthorization from a network doctor or hospital, your doctor will usually seek preauthorization for you, so you don’t need to do anything. But it’s always a good idea to double-check by calling your plan (the numbers are shown below).
Requirements are different depending on your administrator, but here are some common services that usually need preauthorization:
- Inpatient admissions for hospital or behavioral health facilities
- Outpatient surgery, radiology, or dialysis
- Outpatient mental health and substance abuse services
- Home health care
- Rehabilitation services (physical, occupational, or speech therapy)
- Services provided under the Centers of Excellence program.