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Full Version: Claims and Appeal Procedures -- pre-service claim
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JD698
Can a pre-service claim be denied for failure to obtain precertification if it is required or is the remedy for this failure imposing a penalty?
JanetM
Depends on the plan. What does it say about failure to precert procedure?

Most common is impose a penalty for failure to follow pre-service requirements. Have not actually seen plan that flat out denys the claim for failure to precert.
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