Click on the link for Online Precertification on the left navigation bar.
Complete the Precertification Form. The form is divided into the following sections:
Patient Information
Service Information
Treatment/Service/Supply
Physician Information
Facility Information
(Note: All fields on the Precertification Form that require information will be indicated by a green asterisk.)
When the Precertification Form is complete, either click on the Previous button to review previous sections of the form, or click the Finish button to submit.
Once the Precertification Form has been submitted, a summary of the information will display on screen with the option of printing the summary or returning to the first page of the Precertification Form. An e-mail containing the precertification information will then be sent to ACM for review.