Precertification covered benefit pe

Precertification covered benefit penaltyThis only applies to out-of-network coverage: The certificate of coverage contains a complete description of the precertification program. You will find details on precertification requirements in the Medical necessity and precertification requirements section.Failure to precertify your eligible health services when required will result in the following benefit penalty: A $500 benefit penalty will be applied separately to each type of eligible health servicesThe additional percentage or dollar amount of the recognized charge which you may pay as a penalty for failure to obtain precertification is not a covered benefit, and will not be applied to the out-of-network policy year deductible amount or the maximum out-of-pocket limit, if any.