bcbs of alabama precertification template

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to determine if your employer plan is subject to these additional precertification requirements, your benefit booklet will say “the plan benefits are underwritten” in the administrative section at the end of your benefit booklet. precertification is a determination by your health plan that the recommended medical service, supply or drug meets the definition of medical necessity under your plan. the definition of medical necessity can be found in the definitions section of your benefit booklet.

it is your responsibility to ensure that you or your provider gets precertification. if you are covered under an underwritten plan and your benefit booklet refers you to alabamablue.com/precert for additional precertification requirements, the following services or supplies require precertification under your plan: yes, precertification is required for certain prescription drugs. you can find a list of the drugs that require precertification in the prescription drug guide.

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instructions: please complete this form and attach as your cover sheet along with supporting documentation and appeals to blue cross and blue shield of alabama . amounts paid as a penalty (for example, failure to precertify). complete the report suspected fraud and abuse form; call 1-800-824-4391. precertification/pre-procedure review/ , jiva blue cross, blue cross for providers, blue cross for providers, bcbs alabama remittance, bcbs of alabama provider enrollment

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