Teamsters Joint Council No. 83 of Virginia
Health & Welfare and Pension Funds
Pre-certification
All inpatient admissions require pre-certification. This includes admissions for surgeries, skilled nursing facilities (for patients requiring rehabilitation from hip replacements, strokes, etc.), and treatment centers for psychiatric conditions and/or substance abuse disorders. No need to request pre-certification/prior authorization of any Durable Medical Equipment (DME) for rental. Pre-certification/prior authorization is still required for purchases of Durable Medical Equipment that cost $1,000 or more.
Elective Inpatient Admission
Pre-certification must be made at least 5 days preceding any elective inpatient admission. For pre-certification, call Anthem's Healthlink at 1-877-284-0102.
Failure to pre-certify will result in a $500 penalty to the Fund's payment. No payment will be made for any services not authorized.
Emergency Inpatient Admission
Pre-certification must be made within 2 days of any emergency inpatient admission.
Procedures Requiring Pre-certification
Pre-certification must be made at least 5 days preceding the outpatient procedures listed below.
- All inpatient admissions. This includes admissions for surgeries, skilled nursing facilities (for patients requiring rehabilitation from hip replacements, strokes, etc.), and treatment centers for psychiatric conditions and/or substance abuse disorders.