Pre-certification information for the Federal Employee Program*

The Anthem Blue Cross and Blue Shield 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. 

 

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.}