UM Operations
Precertification
Draft — pending verification
This reference entry has not yet been verified against its authoritative source (Original definitions; regulatory facts to be verified against CMS-0057-F (89 FR 8758) and X12/HL7 documentation). Do not rely on it for production configuration until this notice is removed.
In more depth
The X12 278 world tends toward "certification" vocabulary (certification type codes, certification numbers), while policy discussion says "prior authorization." When mapping between UM platforms and EDI transactions, treat them as the same workflow with different naming conventions.