PRECERTIFICATION AND REFERRALS
Precertification, also known as prior authorization, is mandated by many insurance providers requiring designated procedures to be reviewed for medical necessity and approval prior to being provided.
Once we receive the oneForm, we submit for precertification to insurance. Either Neurocare or the payor will reach out to the referring physician if any additional information is required.
Please note that precertification processing time can vary by payor. For more information, please call us at 617-796-7766.
Some insurances require that a Referral be obtained for services that are not considered primary care. Usually, the referral number must be obtained directly by the PCP’s office when a referral is made to another specialist and/or to another healthcare provider (such as a sleep center). Separate referral numbers are required for each referral.
If the consulting specialist orders a sleep study, some providers will still require that the PCP obtain the referral number for the sleep study. Masshealth, Tricare, Network Health, and some Blue Cross are examples of payors that may require referrals for some plans. If a payor requires a referral, we are unable to move forward with the scheduling process until the provider submits the referral.
Once a referral is obtained, please fax to: