Inpatient Hospital Admissions and Second Surgical Opinions

All inpatient hospital admissions must be precertified with the medical review agency. Preadmission certification is required even if the individual is admitted by a preferred provider to a preferred facility.

If a physician recommends a surgical procedure listed on the second surgical opinion list, the individual must contact the medical review agency even if the surgery is recommended by a preferred provider.

Helpful Hint

You may have surgery scheduled at a preferred facility with a preferred surgeon. However, a nonpreferred anesthesiologist or other nonpreferred provider may be used during the surgical procedure without your knowledge. This may result in additional out-of-pocket expenses for you. Please share this concern with your preferred provider prior to any surgical procedure.

---