|Precertify FEP Hospital Admissions |
When a contracting facility or service provider fails to obtain the required precertification or notification on behalf of a Federal Employee Program member, Wellmark is required to apply a $500 benefit reduction.
The member cannot be billed for this amount.
This change in benefits occurred January 1, 2011. Wellmark will begin administering the reduction effective July 1, 2011.
Hospital precertification is required before elective admissions and following emergency admissions for all FEP members:
Before being admitted for inpatient care, including mental health/substance abuse admissions and admissions for other medical care
Within two business days following a hospital admission for emergency care
When a maternity stay extends beyond two days for vaginal or four days for cesarean delivery
For extended newborns stays
To begin the process, call 800-532-1537.
Other Services Requiring Precertification
In addition to hospital admissions, the following continue to require precertification for FEP members. Please contact us before these admissions:
If you have questions, contact our FEP Customer Service area at 800-532-1537.