2024 Select Precert Content
Utilization Management Program and Precertification
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. For the next step in obtaining a precertification, please call Customer Service at the number on the back of your member ID card.
Select Outpatient/Office Services
The following services are included in this category and will require precertification:
- Artificial disc
- Balloon Ostial Dilation
- Blepharoplasty, Brow Lift or Ptosis Repair
- Gastric Restrictive Procedures
(if covered by the group plan) - Gynecomastia Surgery
- Implantable Bone Conduction Hearing Aids
- Knee Arthroplasty
- Lumbar Spinal Fusion
- Panniculectomy/excision of redundant skin or tissue
- Rhinoplasty
- Sacroiliac joint fusion
- Surgery for Obstructive Sleep Apnea
- Surgery for Varicose Veins
- Tumor-treatment fields therapy
Please see the Medical Necessity and Precertification section of your benefit booklet to determine what services require precertification under your plan.
