Precertification list change
Material Adverse Change (MAC)
Please refer to the attached list for services that will be added to precertification list for the effective dates noted below.
To obtain precertification, providers can access Availity* via empireblue.com/provider or call our Utilization Management department using the number on the back of the member’s identification card. Service preapproval is based on member’s benefit plan/eligibility at the time the service is reviewed/approved.
Precertification can help avoid unnecessary charges or penalties by helping to ensure that the member's care is medically necessary and administered at an appropriate network facility and by a network provider.
October 2022 Newsletter