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 provider 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 provider 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. Please share this concern with the preferred provider prior to any surgical procedure.

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