Pre-eligibility enables Impact to inform the member about provider options.
Providers are required to check for pre-eligibility for any of the following treatments to be eligible for sharing:
- Cancer Treatment
• Elective Cardiac Procedures
• Non-emergency inpatient/outpatient surgery
• Organ/Tissue Transplant Services
• Maternity
• Imaging: MRIs and Nuclear Imaging (i.e. PET scans)
Providers must request a pre-eligibility review by calling (855) 378-6777 or online.
3-5 business day notice required, expedited review on a case-by-case basis. Medical records are required to determine pre-eligibility and failure to provide requested records for review will result in the bill being ineligible for sharing.