Products & Programs Federal Employee Program (FEP)CommercialSeptember 30, 2019

Pre-certification information for the Federal Employee Program

Beginning January 1, 2024, Empire became Anthem. This article, published under the former brand, now applies to Anthem.

The Empire BlueCross BlueShield (“Empire”) Service Benefit Plan®, also known as Federal Employee Program®, FEP®, would like to share information about the turnaround times for urgent or non-urgent precertification requests. 

 

Empire FEP follows the National Committee for Quality Assurance (NCQA) standards for turnaround time for urgent or non-urgent precertification requests which are outlined below:

  • Urgent concurrent - 24 hours (1 day)     
  • Urgent preservice - 72 hours (3 days)
  • Non-urgent preservice - 15 calendar days
  • Post-service - 30 calendar days

 

In addition, Empire FEP offers an advanced benefit determination (ABD) for elective services.

  • ABD – 15 calendar days

 

This precertification service is offered as a courtesy. If you would like more information regarding the ABD review process or have additional questions, please contact FEP Utilization Management at 800-860-2156, 8:00 a.m. – 7:00 p.m., Monday-Friday. 

PUBLICATIONS: October 2019 Empire Provider News