Health Plans, Inc. requires pre-certification for certain medical services and procedures. However, individual self-insured plans may require pre-certification for other services that are not listed here.
Please contact Care Management Services at Health Plans, Inc. to verify if a planned procedure requires pre-certification:
- Toll-free: 866-325-1550
- Fax: 508-756-1382 or 508-329-4840
- Contact Us
Click here for a list of services and procedures that require pre-certification.
Please consult the member’s plan Summary of Benefits and Coverage (SBC) to determine if a service requires a review is required, or if benefit limitations or exclusions apply.