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|Do I need to contact my insurance company for pre-authorization or pre-certification?|
For all inpatient stays, a registrar in the Pre-Service Department will call your insurance company to obtain a non-clinical authorization. Outpatient procedures and testing usually require clinical information from your physician to be authorized or certified. A registrar from the Pre-Service Department will call your insurance company to see if the physician has provided the necessary clinical information. In the event your physician has not contacted your insurance company, a registrar will notify the physician's office to contact the insurance company.
If you are unable to pre-register prior to your procedure or admission you should contact your insurance company. Please confirm your pre-authorization requirement and check if it has been completed by your physician's office. Many insurance companies require prior authorization or recertification for medical services.
Carolinas HealthCare System makes every attempt on your behalf to provide information requested by your insurance company which will allow them to make a coverage determination. Although we provide this information for coverage determination, Carolinas HealthCare System cannot guarantee approval from your insurance carrier.