As a case manager for Sentinel, I frequently get calls asking if a procedure or service requires precertification. Internal programs allow me to quickly pull up the patient and the group’s precertification requirements. For most cases a good rule of thumb is that the following DO NOT require precert-
- X-rays, CT scans, MRIs (except for a Breast MRI); and,
- Emergency Room Care if treated and released; and,
- Doctor’s office visits.
I welcome all phone calls and Sentinel’s staff is always happy to assist clients with such questions. In addition, when you call you immediately connect to a live person. But did you know the precertification information can be found on our website under Precert Guide Lookup in the toolbar? All you need is a Member ID and Group number, click View Guidelines and a printable listing is displayed.
Now you know, Sentinel is also just a click away!