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Precertification

When Do I Need to Get Precertified?
*Note: Precertification is not an optional service. It is a requirement for all of the below issues. There is a 30% penalty for not precertifying, which can add up to a lot of lost reimbursement money.

The following services require Precertification:
• Hospitalization (ER services counted as hospitalization) – You must contact WEA within 72 hours if being admitted to the hospital for an emergency
• Admission to an Extended Care Facility
• Diagnostic Testing
• Surgery requiring general or local anesthesia
• All Cancer Treatment
• Home Health Care
• Organ Transplants
• Repatriation of Mortal Remains/Burial Services
• Medical Air Evacuation
• Rehabilitation Services

 

Lately, our office has been seeing more and more cases come through where the client did not precertify with WEA ahead of time. There is a 30% penalty for not precertifying, which can add up to a lot of lost reimbursement money. This has always been WEA’s policy and is stated in the Policy Wording that is accessible through your member portal. Precertification is a requirement for every International insurance company, including WEA. Please contact us if you’d like a copy of the policy wording sent to you via email.

Barbara, who has been with us over a year, is in San Miguel de Allende to assist our clients with Claims and Precertifications. She can be reached at admin@weexpats.com and is available to meet as requested.

The Process
You will need to fill out a Precertification form and will need information from your doctor. You can find the form in your LyncPay member portal. (Please contact us if you need help setting it up and logging in.) You will need to provide the following along with the form:
• Date of onset symptoms *WEA requires a numerical date on the Dr’s medical notes/records
• All current medical notes regarding issue
• Doctor’s recommendation for care regarding issue – diagnostic testing, surgery, etc.
• Estimate of cost of treatment, including a hospital breakdown of estimate of cost, eg. medical equipment, assistant, etc.

The timing
It will take 5 to 7 business days to get a precertification processed, as long as everything has been submitted properly. If they request more information, it will take longer. In case of emergencies, pain, and your health in general, please don’t wait for the precertification process to finish. We can get it started, and go from there. Your health is the number one, important issue.
If you are having an emergency seek immediate help. Notify WEA within 72 hours of being admitted to the hospital. The worldwide number is 404.591.2872, US toll-free is 800.595.1892
The most common problems we have with precertifications are:
• Missing information
• Incorrectly filled in form
Your health is our priority. Please get in touch with any questions or concerns.

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