What services require pre-certification through MagnaCare?

Under the PHBP Medical Plan, all hospital admissions and surgical procedures performed in a hospital facility or surgi-center require pre-certification through MagnaCare. Other services requiring pre-certification include:

• Specialized radiology procedures such as MRI, MRA, CAT, SPECT and PET Scans if determined by MagnaCare to be medically necessary to be performed in a hospital setting. If these services are not deemed to be medically necessary to be performed in a hospital, these services will not be covered in a hospital setting. They can be done in a free standing facility.
• Initiation of dialysis center placement
• Home health care or hospice in conjunction with a hospital discharge
• Durable medical equipment in conjunction with a hospital discharge
• Discharge planning
• Out-patient therapies, including physical, occupational, speech, cardiac, and respiratory therapies

The toll-free phone number for any pre-certification through MagnaCare is (877) 624-6210. Listen to the message prompts and press the selection for pre-certification.