AZ Blue Best Life Plus (HMO): Outpatient Surgery

Many surgeries today are performed in ambulatory surgical centers or outpatient hospital facilities and do not require a hospital stay.

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Cost
$150 copay at ambulatory surgery center; $200 copay at hospital outpatient facility
Prior Authorization Required
Yes, except in an emergency
Provider Referral or Order Required
Yes

How To Receive

Details on how to apply

  1. Obtain a provider order for outpatient surgery.

  2. Contact the AZ Blue Best Life Plus Team at 1-800-446-8331 (TTY 711) for prior authorization.

    • The ordering provider may help with authorization.

  3. Schedule the procedure at a network surgery center chosen by the provider.

  4. Attend the appointment and complete the procedure.

  5. After surgery, engage in recommended follow-up treatment and/or referrals.

Availability
Ongoing, as ordered and authorized

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Outpatient surgery is also referred to as "same-day" surgery and "ambulatory" surgery.

Many surgeries today can be performed on an outpatient basis and do not require admission to the hospital. Examples include but are not limited to, knee and hip arthroplasty/replacement, removal of non-malignant growths, cataract surgery, and laparoscopies.

When having surgery in a hospital facility, however, check with the provider about the expected inpatient or outpatient status following the surgery. Unless the provider writes an order for inpatient admission to the hospital, the status will be outpatient, and payment of cost-sharing amounts for outpatient surgery is required. Even with an overnight hospital stay, it may still be considered outpatient.

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