Pre-Certification/Pre-Notification
PLEASE READ: Members of some group health plans may have terms of coverage or benefits that differ from the information presented here. The following information describes the general policies of CareFirst Administrators and is provided for reference only. This information is NOT a guarantee of payment. To verify coverage or benefits or determine pre-certification or pre-notification requirements for a particular member, call 866-945-9839, or send an electronic inquiry through your established connection with your local Blue Plan.
Services that Require Pre-certification
- Inpatient Admissions (includes hospital, extended care facility, skilled nursing facility, rehabilitation facility)
Services that Generally Require Pre-notification
- Chemo Therapy (initial treatment only)
- CT Scans
- Durable Medical Equipment in excess of $2,500
- Infusion Therapy (initial treatment only)
- Organ Biopsy
- Out-Patient Surgery
- Radiation Therapy (initial treatment only)
- Renal Dialysis (initial treatment only)
