Oct 1, 2019 • State & Federal / Federal Employee Plan (FEP)

The Empire BlueCross BlueShield (“Empire”) Service Benefit Plan®, also known as Federal Employee Program®, FEP®, would like to share information about the turnaround times for urgent or non-urgent precertification requests. 

 

Empire FEP follows the National Committee for Quality Assurance (NCQA) standards for turnaround time for urgent or non-urgent precertification requests which are outlined below:

  • Urgent concurrent - 24 hours (1 day)     
  • Urgent preservice - 72 hours (3 days)
  • Non-urgent preservice - 15 calendar days
  • Post-service - 30 calendar days

 

In addition, Empire FEP offers an advanced benefit determination (ABD) for elective services.

  • ABD – 15 calendar days

 

This precertification service is offered as a courtesy. If you would like more information regarding the ABD review process or have additional questions, please contact FEP Utilization Management at 800-860-2156, 8:00 a.m. – 7:00 p.m., Monday-Friday. 


Featured In:
October 2019 Empire Provider News