Jul 06

Did You Know?

by Jess

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-

  1. X-rays, CT scans, MRIs (except for a Breast MRI); and,
  2. Emergency Room Care if treated and released; and,
  3. 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!

Just J & B:

Bob

Bob is a managed care coordinator who in 1984 started as a compliance analyst for credit and mortgage insurance. Later he shifted to major medical. This staff member has spent countless hours reviewing claims, medical policy and has a lot to say about both.

Jess

Jess is a nurse case manager dedicated to patient advocacy after receiving her RN license in 1998. This long time staff member provides her unique perspective based on thousands of conversations held with patients and providers.

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