Ancillary Services
This type of service is done when you are getting a Pre-op Wellness check.
Example: A biopsy of a mole, bloodwork, urinalysis.
What is Laboratory & pathology.
This criteria must be met before prior authorization is approved.
What is Medical Necessity?
An ultrasound and Xray for a bone or joint would be considered under this type of Ancillary service.
What is Low Tech Radiology?
This type of surgery is not normally covered. Unless it is considered a medical necessity to treat breast cancer.
What is Cosmetic Reconstructive Surgery?
These services and screenings exams may require Prior authorization:
Heart Stress Test
Imaging (MRI & CT Scan)
Scopic Procedures (Colonoscopy & Upper Endoscopy)
What is High Tech Radiology?
Laparscopic Adjustable Gastric Band procedure (Laparoscopy) is another name for what kind of procedure?
What is Bariatric Surgery?
This service has CPT code of 99100 and is defined as insensitivity to pain.
ALWAYS ALWAYS ALWAYS check the ____ details for Member Cost Share information.
What is Benefit Summary Cost Share?