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.

Additional Medical Policies