29 PHS+ Precertification Program The Plan requires that certain outpatient surgical procedures, diagnostic testing and all non - emergency inpat ient hospital admissions be certified in advance. Failure to obtain precertification through Cigna’s PHS+ precertification program can result in your claim being denied. PHS+ precertification will help you and your dependents get the right care, at the ri ght time, in the right place. With PHS+ and its precertification process, you can: • Get the most appropriate inpatient and outpatient care • Find lower cost services • Avoid unnecessary or non - covered medical treatment or procedures • Improve your health with e arlier case management services that help to identify when you might need extra assistance How Precertification Works If you use an in - network provider, you don’t need to do anything for precertification. The Open Access Plus network (OAP) contracted prov ider is responsible for getting the precertification for all required non - emergency in - network services. If you use an out - of - network provider for non - emergency services, you are responsible for necessary precertification. To do this, you will need to call the customer service phone number on the back of your Cigna ID card. A service representative will walk you through the precertification process.
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