The MILA National Health Plan
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Glossary

CLAIMS AND APPEALS

Non-Urgent Pre-Service Claim

A Non-Urgent Pre-Service Claim is a claim for a benefit for which the Plan requires approval of the benefit (in whole or in part) before medical care is obtained. Under this Plan, services that require prior approval are described here.

Important: If you use Out-of-Network providers, the Plan will reduce your reimbursement if you fail to pre-certify certain types of treatment. Please see the discussion relating to these reductions for medical treatment here and for mental health or substance here.

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