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MedCost offices will be closed on Friday, June 19th in observance of Juneteenth. Regular hours will resume on Monday, June 22nd.
Precertification
Some benefit plans include precertification requirements for certain outpatient procedures and procedures that require a hospital stay. Two outpatient review program options are available from MedCost: Advanced Imaging and Comprehensive Outpatient Review. If a member’s benefit plan includes any precertification requirements, it will be indicated on the member’s ID card.
Please consult the member’s ID card for precertification requirements.
- If the member has advanced imaging precertification requirements, all elective CT, MRI, and PET scans should be pre-certified.
- If the member has comprehensive outpatient review precertification requirements, several outpatient services and surgeries/procedures, along with advanced imaging (all elective CT, MRI, and PET scans), should be pre-certified. A complete list of Comprehensive Outpatient Review Services is located at www.MedCost.com/CompOPR.
For members with MedCost listed as the precertification contact on the back of the ID card, please call 800-722-2157 and select Option 2 to initiate certification. Or, fax your request to 336-970-2098.
Note: Precertification is not a guarantee of payment.