The following services require a Pre-Authorization- subject to deductible requirements:
- Imaging Services- MRI, CAT Scans, PET Scans, CT/CTA and Nuclear Cardiac Studies
- Inpatient Hospital Facility Services EXCEPT in emergencies or hospital stays for a mother and her newborn of up to 48 hours following a vaginal delivery and 96 hours following a cesarean section
- Inpatient Mental Health & Substance Abuse Services- including rehabilitation and partial hospitalization except in emergencies.
Pre-certification phone number is 800-269-1260.
If you fail to receive pre-certification you may be subject to a $250 fee.
Always feel free to call the customer service number on your Priority card, and access the Health Benefit Plans at
https://www.nmc.edu/departments/human-resources/salaries-benefits/medical-benefits.html#medical