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

Obtain a provider order for outpatient surgery.
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.
Schedule the procedure at an in-network surgery center chosen by the provider.
- It is likely that the scheduling department of that facility will reach out to schedule the surgery.
- The facility may also help with authorization.
- Search in-network hospital surgery centers.
- Search in-network ambulatory surgery centers.
Attend the appointment and complete the procedure.
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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