Companion Benefit Alternatives

Precertification

A member’s health plan benefits determine if you must get prior approval for services. In many cases, if the health plan requires precertification and you do not get it, the health plan may reduce or deny your reimbursement.

Learn more on our Precertification 101 page. You can also get details on how to request precertification online.

Precertification Process

  1. Determine if the member is eligible for benefits under his or her health plan.
  2. Determine if the service is a covered benefit under the health plan. If so, determine if benefits are still available.
  3. Determine whether the health plan requires prior approval for the service.
  4. Request authorization if the health plan requires it for the service. Otherwise, the health plan will not cover the service. You can request authorization online in our Form Resource Center.