Pre-authorizations are needed for members who need pre-existing/stand-alone bloodwork, any advanced imaging, or an upcoming procedure (inpatient or outpatient). Your provider needs to contact netWell directly. This will allow us to ensure that we have obtained everything necessary to process your upcoming medical expenses (ie. a 2 year look back of medical records, etc.). This process can take up to 10 business days for the determination to be sent to the requesting provider.

Emergencies happen though, and we are still here to help you navigate through these stressful steps. If you or another member are hospitalized, or if you have an emergency visit, your provider has up to 72 hours to call and/or submit a retro pre-authorization request.

If your provider disagrees with the determination made, they are always welcome to resubmit a new pre-authorization request or call us directly. However, it will be required to have additional supporting documentation and/or addendums to the medical records utilized for this original determination.

For further information, please reference the “Pre-authorization” section of your member guide. You are also welcome to give us a call for questions, comments, or concerns related to this process.

Link to Pre-authorization Form Click Here