PPO Plan Outpatient Fees & Surgery Requirements - Must READ

PPO Outpatient Fees
Hip, Knee And Spine Surgeries Blue Distinction+ Requirement
Carrum Flyer

PPO plans have certain rules including utilization review on certain procedures. The member MUST take the time to review your plan documents to understand the rules of coverage.

The member must use in-network providers and facilities to be covered by the plan.

**COLONOSCOPY**

The member must ensure the medical provider receives a pre-authorization for the anesthesiologist BEFORE a colonoscopy or the charges may not be covered.

The procedure MUST take place in a surgical center unless pre-authorized by Anthem.

Please call Anthem if you have any questions before any procedure.