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Table of Contents |
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| Detailed Table of Contents | |
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Your Rights and Responsibilities
How the Retiree Group Health Program Works
How the Prescription Drug Program Works
Your Legal Right to Continuation Coverage
Coordinating Benefits With Other Programs
ERISA Claims and Appeals Procedures
Situations Affecting Your Benefits
Retiree Medical, Prescription Drug and Mental Health and Substance Abuse Programs - RR Donnelley
How the Retiree Group Health Program Works
Preadmission Certification - CIGNA
How to Precertify Your Hospital Admission
If you or your spouse is younger than age 65, you or your spouse must call the claims administrator to precertify a scheduled hospital admission at least 24 hours before you or your spouse is admitted. When you or your spouse calls, be prepared to provide information regarding your upcoming hospitalization, including the full name, address, and phone number of your provider.
The claims administrator’s toll-free phone number is listed on your ID card. Your regular physician or authorized specialist may work directly with the claims administrator to obtain approval for your admission. However, it is your responsibility to make sure your hospital stay is approved.
A health care professional reviews your request, and you or your spouse and your physician or your spouse’s physician is notified as soon as possible regarding the approved length of stay. If the request for hospitalization is not approved, the claims administrator discusses the case with the provider to reach an agreement regarding the appropriate treatment to follow.
