Get easy access to information that helps you understand what may or may not be covered by your patients' health insurance or health benefits plans; read up on the reasoning behind the decisions
* The term precertification here means the utilization review process to determine whether the
requested service, procedure, prescription drug or medical device meets the company's clinical
criteria for coverage. It does not mean precertification as defined by Texas law, as a reliable
representation of payment of care or services to fully insured HMO and PPO members.