For Physicians
Precertification Helpful Tips
| INSURANCE | INSURANCE | INSURANCE | REQUIRED INFORMATION | ADDITIONAL INFORMATION |
AETNA HMO AND PPO |
888-693-3211 | KCIC May Initiate, Referring Office To Provide Clinical Information | Member Insurance Id #, DOB, Ordering Dr., Procedure, DX and CPT Codes, any Relevant History & treatment | MRI & CT need precertification, Must call Medsolutions |
ADVANTRA FREEDOM & MEDICARE ADVANTAGE |
800-713-5095 OR 800-727-9712 | KCIC May Initiate, Referring Office To Provide Clinical Information | Member Insurance Id #, DOB, Ordering Dr., Procedure, DX and CPT Codes, any Relevant History & treatment | MRI & CT Need to be called and checked on for both Advnatra Freedom and Advantra Medicare |
BCBS ANTHEM ALL |
Refer to # on card | Referring Office To Call | Member Insurance ID #, DOB, Ordering Dr., Procedure, DX and CPT Codes, any Relevant History & treatment | |
BCBS OUT OF STATE ALL |
Refer to # on card | KCIC May Initiate, Referring Office To Provide Clinical Information | Member Insurance ID #, DOB, Ordering Dr., Procedure, DX and CPT Codes, any Relevant History & treatment | |
BCBS PREMIER BLUE ALL |
Refer to # on card, requires paper referrals | Referring Office To Call | This is a paper referral that must come from the PCP. A specialist cannot submit referral, a specialist can call PCP to have referral submitted. | |
BEECHSTREET ALL |
888-693-3211 | KCIC May Initiate, Referring Office To Provide Clinical Information | Member Insurance ID #, DOB, Ordering Dr., Procedure, DX and CPT Codes, any Relevant History & treatment | MRI and CT are authorized through Medsolutions. |
COVENTRY HMO AND PPO |
877-837-8914 | KCIC May Initiate, Referring Office To Provide Clinical Information | Member Insurance Id #, DOB, Ordering Dr., Procedure, DX and CPT Codes, any Relevant History & treatment | MRI only needs precertification |
CIGNA HMO AND PPO |
888-693-3211 | KCIC May Initiate, Referring Office To Provide Clinical Information | Member Insurance Id #, DOB, Ordering Dr., Procedure, DX and CPT Codes, any Relevant History & treatment | MRI & CT need precertification, Must call Medsolutions |
FREEDOM/PHP BALLS/HEN HOUSE/PRICE CHOPPER |
Refer to # on card | Referring Office To Call | Member Insurance Id #, DOB, Ordering Dr., Procedure, DX and CPT Codes, any Relevant History & treatment | Balls/Price Chopper/Hen House need authorization. Any Union, Plumbers Local, etc.. Does not need an auth. All others need checked on. |
GREAT WEST ALL |
888-693-3211 | KCIC May Initiate, Referring Office To Provide Clinical Information | Member Insurance Id #, DOB, Ordering Dr., Procedure, DX and CPT Codes, any Relevant History & treatment | MRI & CT need precertification, Must call Medsolutions |
GEHA ALL |
Refer to # on card and call MEDSOL for MRI & CT at 888-693-3211 | KCIC May Initiate, Referring Office To Provide Clinical Information | Member Insurance Id #, DOB, Ordering Dr., Procedure, DX and CPT Codes, any Relevant History & treatment | MRI and CT are authorized through Medsolutions even though all claims go directly to GEHA. |
HUMANA ALL |
866-825-1550 | Referring Office To Call | Member Insurance Id #, DOB, Ordering Dr., Procedure, DX and CPT Codes, any Relevant History & treatment | HMO requires referrals for all exams & PPO requires authorizations for MRI & CT |
TRICARE PRIME & STANDARD & TRICARE LIFE |
888-874-9378 | Must Initiate via Fax With All Clinical Information by Facility or Referring Office | Member Insurance Id #, DOB, Ordering Dr., Procedure, DX and CPT Codes, any Relevant History & treatment | MRI Brain and all Spines require authorizations, Prime, and ADSM require referrals |
UNICARE ALL |
866-408-7105 | KCIC May Initiate, Referring Office To Provide Clinical Information | Member Insurance Id #, DOB, Ordering Dr., Procedure, DX and CPT Codes, any Relevant History & treatment | MRI & CT require authorizations, 1 OB sono is ok, after 1, needs authorization |
UHC ALL |
877-842-3210 | Referring Office To Call | Member Insurance ID #, Grp #, DOB, Procedure, DX and Relevant History | MRI & CT require notification #, facility can check on but MAY NOT initiate |
