Pre-Verification and referrals
Most insurance plans require you to obtain a referral from your primary care physician, and/or an authorization or pre-certification that provides the proof that the services you will be receiving at the hospital are approved. If this type of approval applies to you, then you will be asked for one or more of the following:
- Pre-certification/authorization number
- PCP name
- PCP phone number
- PCP referral
- Referral expiration date
If you are not covered by an insurance plan, you or a family member can contact our financial counselors prior to your visit. A counselor will help you determine alternative sources of funding and/or payment options.
Pre-verification of your benefits should take place prior to your admission and outpatient services. If you are treated in the Emergency Department, verification of benefits will occur prior to discharge when at all possible.
Insurance co-payments and deductibles will be collected at the time of service. If you are an HMO patient or patient participating in a managed care program, you must provide a written authorization or a referral from your HMO or primary care physician at the time of service.
Please note that many insurance companies require pre-certification prior to services being rendered. It is important to familiarize yourself with your benefit requirements to be sure that you receive maximum reimbursement from your carrier.