Understanding the Member Preauthorization Process
Prior to receiving a medical service or procedure, you may be required to obtain approval from your health insurance plan. This is known as “member preauthorization” and ensures that you are receiving safe, appropriate care. A detailed list of services requiring preauthorization is included in your contract (“Certificate of Coverage”).
How It Works
If you require a service on Independent Health’s member preauthorization list, you are responsible for obtaining approval by calling the Member Services Department at (716) 631-8701 or 1-800-501-3439. While your provider may also do this on your behalf, keep in mind that it is your responsibility to ensure preauthorization is obtained from Independent Health prior to receiving these services to avoid potential financial penalties.
The request for member preauthorization should be made 15 calendar days in advance of the service(s) being rendered, or within 48 hours of the first business day following emergency services and/or admission.
Independent Health will review the member preauthorization request, which may take 3 to 5 business days. Once a decision is made, you will be notified in writing of the decision.