Teamsters Joint Council No. 83 of Virginia

Health & Welfare and Pension Funds

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Pre-certification and Notification

Pre-certification by Hines & Associates, Inc. is required for inpatient admissions and certain outpatient procedures listed below. To begin the pre-certifcation process online, visit www.precertcare.com

Elective Inpatient Admission

Pre-certification must be made at least 5 days preceding any elective inpatient admission. For pre-certification, call Hines & Associates. at 1-888-852-8382. Failure to pre-certify will result in a $500 penalty to the Fund's payment. No payment will be made for any services not authorized by Hines & Associates.

Emergency Inpatient Admission

Pre-certification must be made within 2 days of any emergency inpatient admission. For pre-certification, call Hines & Associates. at 1-888-852-8382. Failure to pre-certify will result in a $500 penalty to the Fund's payment. No payment will be made for any services not authorized by Hines & Associates.

Procedures Requiring Pre-certification

Pre-certification must be made at least 5 days preceding the outpatient procedures listed below. For pre-certification, call Hines & Associates at 1-888-852-8382. Failure to pre-certify will result in a $500 penalty to the Fund's payment. No payment will be made for any services not authorized by Hines & Associates.

  • Abdominoplasty
  • Artificial Intervertebral Disk Implantation
  • Artiovenous (AV) Fistula for Dialysis
  • Automated Percutaneous Lumbar Diskectomy (APLD)
  • Automatic Implantable Cardioverter Defibrillator (AICD) Insertion
  • Bariatric (weight loss) surgery
  • Biventricular Device Insertion
  • Blepharoplasty
  • Breast Reduction
  • Capsule Camera Endoscopy
  • Colonoscopy (virtual)
  • Durable medical equipment where total rental or purchase price exceeds $1,000
  • Educational/Nutrition classes for a new diabetes diagnosis
  • Excess Skin Removal – arms, chest, and legs
  • Graphed Access for Dialysis
  • Home Health Care (all services, supplies, equipment and procedures, excluding those listed requiring notification only in the list below)
  • Hysterectomy
  • Intradiscal Electrothermal Annuloplasty (IDET)
  • Lithotripsy (Shock wave for Plantar Fasciitis)
  • Maxillo-facial surgery
  • Nasal surgeries (all)
  • Orthopedic Surgeries with Implants (implants are defined as any medical device that is permanent and will not be removed)
  • Orthotics over $2,000
  • Panniculectomy
  • Percutaneous Radiofrequency Neurotomy
  • Prosthetics over $2,000
  • Sclerotherapy
  • Spinal Surgeries (all, not including injections)
  • Uvulopalatopharyngoplasty (UP3/UPPP)
  • Varicose Vein Surgery
  • Ventral Hernia Repair
Procedures Requiring Notification

Notification must be given to Hines & Associates for any of the procedures listed below. Failure to pre-certify will result in a $500 penalty to the Fund's payment. No payment will be made for any services not authorized by Hines & Associates.

  • Biopsies(excluding dermatological)
  • CT Angiogram
  • CT Calcium Screening
  • CT (all related to oncology)
  • In home services limited to hospice, occupational therapy, physical therapy, speech therapy, and sleep studies
  • MRI (all related to oncology)
  • MRI (heart)
  • PET scan (all related to oncology)
  • Occupational therapy over 20 visits per calendar year
  • Physical therapy over 20 visits per calendar year
  • Speech therapy over 20 visits per calendar year