PCU Blog
If I Pre-certify, are medical benefits guaranteed?
No. The amount, if any, of benefits available can only be determined once all details of your claim and complete Proof of Claim has been submitted.
Am I required to Pre-certify medical expenses?
The following medical expenses must always be Pre-certified: a. Inpatient care b. Any Surgery or Surgical Procedure c. Care in an Extended Care Facility d. Home Nursing Care e. Durable Medical Equipment f. Computerized Tomography (CAT Scan) g. Magnetic Resonance Imaging (MRI) h. Interfacility Ambulance Transfer i. Ultrasound j. Positron emission tomography scan (PET) k. […]
Will payment for my claim be reduced if I do not Pre-certify a medical expense that is required to be Pre-certified?
Yes. We will reduce Eligible Medical Expenses by 50%, and then apply your Deductible and/or Coinsurance if applicable.
