To obtain medical precertification members should contact the Anthem Blue Cross Blue Shield precertification area at 1-866-776-4793.
Precertification may be required for the following services (not all-inclusive):
- Inpatient Care provided under the Plan with the exception of required maternity admissions.
- Maternity and/or Newborn Inpatient care beyond 48 hours for a normal delivery or 96 hours for a cesarean section.
- Mental Health Benefits for Inpatient, Intensive Outpatient, Partial Hospitalization and Residential Treatment Services.
- Substance Abuse Benefits for Inpatient, Intensive Outpatient, Partial Hospitalization and Residential Treatment Services.
- The purchase, rental, repair or replacement of Durable Medical Equipment.
- All Outpatient intravenous therapy and related services.
- Outpatient Surgery at Hospitals and Ambulatory Surgery Facilities.
Please note: In case of an emergency care admission, the member must notify Anthem BCBS within two business days after the admission.
If you are unsure if a service needs precertification, feel free to contact the Anthem customer service area at 1-877-512-7875 to inquire if precertification is needed for a specific service or procedure.