Utilization Management Program and Precertification

This webpage applies only to Blue Cross and Blue Shield of Alabama individual and family (non-group) plans and underwritten employer group plans. To determine if your employer plan is subject to these additional precertification requirements, your benefit booklet will say “the plan benefits are underwritten” in the Administrative Section at the end of your benefit booklet.
Please see your benefit booklet to determine what services require precertification under your plan.
Precertification is required for many services, including the following outpatient hospital benefits, physician benefits and other covered services. Below is the list of specific services in these categories that require precertification. This list will be updated no more than twice a calendar year. You should check this list prior to obtaining any outpatient hospital services, physician services and other covered services.