Pre-certification information for the Federal Employee Program*
Anthem 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, Anthem 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.
* Notice of Material Changes/Amendments to Contract and Changes to Prior Authorization Requirements may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements.
October 2019 Anthem Provider News - Ohio