See services requiring precertification/prior-authorization.
This list replaces the applicable section in your Provider Guide. It is subject to change. Changes are communicated via our provider newsletter or Operations Bulletins as necessary.
Members may not be held financially liable for a participating provider's failure to obtain prior authorization/pre-certification.
To request pre-certification, unless otherwise noted, please contact the Health Services Department at (800) 544-3907, or (570) 271-6497, Monday through Friday, 8 a.m. to 5 p.m.
Review guidance for ordering outpatient MRA, MRI, CT scan, PET scan and nuclear cardiology services