Each year, the medical directors at Independence Administrators review the list of medical services and drugs that require precertification under Independence Administrators plan members? medical plans. They consider provider practices, evidence-based medicine, current standards of care, technology changes, and utilization trends. On April 1, 2016, the updated list of services and medications that require precertification will take effect for Independence Administrators plans. This list will be available on the Independence Administrators website under "Procedures and medications that require precertification."

Coordination of precertification requests

Some of the services or supplies on the precertification list may not be covered by a particular Independence Administrators plan member?s medical benefits. When you request precertification, Independence Administrators applies the benefits as defined in the Independence Administrators plan member?s medical plan documents.

It is important that you request required precertification on your Independence Administrators plan member?s behalf. You can request precertification through Independence Administrators in one of the following ways:

• Submit the request electronically through iEXCHANGE^®.
• Call the number on the Independence Administrators plan member?s ID card.

Independence Administrators will apply the specified benefit reduction as described in the medical plan if an Independence Administrators plan member receives a covered service or supply without the required precertification. Independence Administrators will not precertify or authorize items that the Independence Administrators plan member?s plan does not cover. For precertification of behavioral health services, please contact Magellan HealthCare, Inc., an independent company, at the phone number on the plan member?s ID card.

How this may affect prescription drug benefits

Independence Administrators uses this list solely to administer medical benefits. If an Independence Administrators plan member has a prescription drug program through FutureScripts^®, an independent company, the drugs on the medical precertification list are not covered under their prescription plan. However, some medications on the Independence Administrators medical precertification list may be covered through other pharmacy benefit managers? programs.

If you have questions about this update to Independence Administrators? Health Utilization Management program or the updated precertification list, please contact Independence Administrators Provider Relations.

Magellan Healthcare, Inc., an independent company, manages mental health and substance abuse benefits for most Independence members.

FutureScripts and FutureScripts Secure are independent companies that provide pharmacy benefits management services.