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Learn about the precertification review we provide before you receive certain services.
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Services Requiring Precertification
Precertification is the review we provide before you receive certain services. Without precertification, you may have greater out-of-pocket expenses. The review will also ensure that services are eligible under your health plan.
When you receive eligible services from an in-network doctor, health care professional or facility, they are responsible for obtaining precertification. If you receive out-of-network services, you are responsible for obtaining precertification.
For information about the services that require prior authorization, speak with your doctor or other health care professional. You can also sign in to Member Online Services to send a secure email or chat with us in real time. Our chat hours are Monday through Friday, 8 a.m. to 8 p.m., Eastern Time (ET). You can also call the number on the back of your member ID card, Monday through Friday, from 8 a.m. to 6 p.m., ET, to speak with a dedicated SHBP/SEHBP representative.
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