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Precertification & Medical Policies

Review Our Precertification Details and Medical Policies.

Not all procedures require precertification. However, there are some that do. We abide by a set of pre-determined medical policies that provide guidelines, based on scientific evidence, for treatment options and procedures.

The Following Medical Services Require Precertification:

Alternative and Complimentary Medicine
Chiropractic
Diagnostic tests (except plain x-rays)
Durable Medical Equipment over $250 (includes prosthetics)
Electro-mechanical devices
FCE and work conditioning/hardening
Home Health Services
Infusion Therapy
Inpatient Facility Admissions (acute, sub-acute, rehabilitation)

Click here to view this list as a PDF.

Pain Management office visits and treatment (non-interventional and interventional)
Physical and occupational therapy
Psychiatry/Psychology
Specialty referrals/consultations
Surgeries/Procedures
Therapy (bio-feedback, cognitive, psychotherapy)
Wound Care
Wellness/Fitness Programs (Health club and pool memberships)

Chesapeake Employers' Medical Policies

Medical Policies are evidence-based in considering what is reasonable, medically necessary, and non-investigational or experimental medical treatment. These policies assist us in making utilization and authorization decisions.

Artificial Disc Replacement

Bone Growth Stimulator

Carticel Autologous Cultured Chondrocytes

Chiropractic Therapy

Cold Compression

Compounded Medication-Medical Foods

Denovo Nt/Denovo Et Juvenile Cartilage Graft

Epidural Steroid Injection

Facet Injections

H-Wave

Platelet Rich Plasma Therapy

Quantitative Sensory Testing

Shoulder Infusion Pump

Spinal Cord Stimulator

Trigger Point Injections

Additional Medical Policies

Urine Drug Testing Policy (2017)

Urine Drug Testing Policy (2016)

Lumbar Supports & Braces (TSLO)