Preauthorization Procedure. If You seek coverage for services that require Preauthorization, You or Your Provider must call Us at the number on Your ID card. You or Your Provider must contact Us to request Preauthorization at least two (2) weeks prior to a planned service. If that is not possible, then as soon as reasonably possible during regular business hours prior to the service. After receiving a request for approval, We will review the reasons for Your planned treatment and determine if benefits are available. Criteria will be based on multiple sources including medical policy, clinical guidelines, and therapeutic guidelines.
Appears in 41 contracts
Samples: Preferred Provider Organization Insurance Contract, Preferred Provider Organization Insurance Contract, Preferred Provider Organization Insurance Contract
Preauthorization Procedure. If You seek coverage for services that require Preauthorization, . You or Your Provider must call Us at the number on Your ID card. You or Your Provider must contact Us to request Preauthorization at least two (2) weeks prior to a planned serviceservices. If that is not possible, then contact us as soon as reasonably possible during regular business hours prior to the service. After receiving a request for approval, We will review the reasons for Your planned treatment and determine if benefits are available. Criteria will be based on multiple sources including medical policy, clinical guidelines, and therapeutic guidelines.
Appears in 2 contracts
Samples: Preferred Provider Organization Contract, Preferred Provider Organization Contract
Preauthorization Procedure. If You seek coverage Coverage for services that require Preauthorization, You or Your Provider must call Us at the number on Your ID card. You or Your Provider must contact Us to request Preauthorization at least two (2) weeks prior to a planned service. If that is not possible, then contact Us as soon as reasonably possible during regular business hours prior to the service. After receiving a request for approval, We will review the reasons for Your planned treatment and determine if benefits are available. Criteria will be based on multiple sources including medical policy, clinical guidelines, and therapeutic guidelines.
Appears in 1 contract
