Pre-certification is a review of the medical necessity of a particular medical procedure by a nurse case manager at IMG to ensure that the recommended medical service is appropriate for the member according to standard medical practices. It is not a verification of benefits or a guarantee of payment for potential claims. This applies to the Goose International policy and must be completed to avoid a reduction of benefits in the event of a loss.
Where can members find their pre-certification requirements?
The requirements are listed in the policy certificate and on the MyIMG website. Members may also call +1.800.628.4664 (in the U.S. and Canada) or +1.317.655.4500 (outside the U.S.) and press option 3 for Customer Service.
How do members start the pre-certification process?
The member, the treating physician, or the facility providing care may initiate the pre-certification process by using a secure online form, which can be found here. If members are unable to use the online form, they may also email ACM@akesocare.com and provide the contact information for the physician and facility, along with all of the necessary medical information.
Please note that this online service will only initiate the pre-certification process, and it should not be used to pre-certify emergency admissions, procedures, or evacuations.
If an emergency medical evacuation is required, please call us at +1 (317) 655-4500.
How will policyholders know if their procedure has been pre-certified?
For outpatient procedures, members will receive a pre-certification letter via postal mail if members are in the U.S. or by email if members are outside of the U.S. For inpatient procedures, the pre-certification letter will arrive after the member has been discharged. If the member needs immediate confirmation, the member may email ACM@akesocare.com or call +1.800.628.4664 (in the U.S. and Canada) or +1.317.655.4500 (outside the U.S.) and press option 2 for a status update.
How does precertification tie into direct billing?
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