•  Ask a Nurse
•  Pregnancy Support
•  Personalized Case Management
•  Health Support/Disease Management
•  Precertification Initiation
•  PPO Locator Service
•  Non-Network Negotiation and Exception Services

Call our toll-free number, 1-800-253-4641 any time, any day to obtain general medical information, locate preferred providers, receive advice on maximizing your benefits and initiating inpatient precertification.

Ask a Nurse—This program provides you with medical support 24 hours a day, 7 days a week.  By calling our toll-free number, 1-800-253-4641, you will be connected directly with a Registered Nurse who can answer your medical questions and help you and your family.

Pregnancy Support—Our “Building Blocks” pregnancy support program was developed to assist you during your pregnancy.  This service is available to you even if you do not have maternity coverage with PALHIC.  Your Registered Nurse Case Manager will provide you with educational materials and information, and answer your questions.  If you’re faced with a high-risk pregnancy, your nurse will work with your doctor to provide specialized case management.  You can contact a Case Manager by selecting the following link Pregnancy Support.

Personalized Case Management—Our individual case management programs are designed to help those who face catastrophic illness and injury, cancer or organ transplant.  Registered Nurse Case Managers will work directly with you and your doctor to help coordinate your care, identify the best options for you, and assure the common goals of quality, cost-effective care.  We want you and your family to focus on the important issues—recovery and returning to a healthy lifestyle.

To contact a Transplant Case Manager, select the following link Medical Transplant Support
To contact a Cancer Case Manager, select the following link Cancer Case Management
To contact a Medical/Catastrophic Case Manager, select the following link Medical Catastrophic Support
To contact a Health Support/Disease Support Case Manager, select the following link Health Support/Disease Support

Precertification—Precertification is necessary for inpatient hospital admissions and following emergency admissions to determine if medical services or admissions are medically necessary and appropriate.  Precertification will assure that you maximize your medical benefits and have the opportunity to take advantage of our case management services, if appropriate.  Obtaining precertification does not guarantee payment of benefits, since all claims are subject to the terms of the certificate booklet/policy.

Just have your doctor call 1-800-253-4641 to initiate the precertification process.  This precertification requirement varies by state.

Provider Locator Services—Locating a provider is as easy as picking up the phone or clicking your mouse!  Just dial 1-800-253-4641 for assistance with finding a provider in your network.  It’s available to you 24 hours a day/7 days a week.  You can also locate a provider online directly by clicking here.

Non-Network Negotiation and Exception Services—If a PPO provider is not available within a reasonable distance from your home, or if there is no provider within your network who performs the service you require, call 1-800-253-4641.  We will help locate a non-network provider and attempt to negotiate the cost to help you save money.  Our goal is to eliminate or reduce any balance billing.