American Health (formerly
Strategic Health) - Pre-Certification Services
American Health Holding Inc. is your Utilization Review service.
Many times your provider will obtain the certification; however, you are
ultimately responsible. American Health’s toll-free number is also on your ID card.
Call 1-800-874-2378 or go to www.zenithadm.com
and click on American Health to have services pre-certified.
Examples of services which require pre-certification
include the following:
Inpatient admissions such as hospital,
long-term acute care, detoxification, skilled nursing facility, hospice
and extended active rehabilitation (emergency and maternity admissions
do not require pre-certification).
Surgery and other procedures such as
epidural and various scope procedures, performed in an outpatient
facility or the outpatient department of a hospital
Organ/tissue/bone marrow transplants and
stem cell procedures including transplant consultation or evaluation,
and the transplant itself
Home health services, home health infusion
therapy and outpatient therapy services when such services are provided
in the home, and continuous hospice home care
Cancer clinical trials
As a reminder, you do not need a referral to see a specialist.
Pre-certification may or may not be needed for some medical services. Contact
American Health for specific details.
