I am the Business Office Manager for a small rural hospital and I am also the SHIP (Senior Health Insurance Coordinator for the state of Illinois) so I actually work both sides of the spectrum.

We certify every admission and outpatient procedure that we know requires it, we have a utilization review nurse that does this. However, I have sat in on meetings at various employers that are presenting new insurance coverage to their employees.
The employee is given their new insurance card along with their coverage manual. NO where in the meetings or the manuals does it say that the ultimate responsibility for pre-cert is the hospital. The employees are told it is their responsibility for precertification. That statement is even made on the back of their insurance cards.
However, we do certify about 95% because we know it helps us get paid as well as performing a courtesy for our patients and try to take away a lot of their concerns.
Sometimes there is the occassional patient that says he is self pay and then when we bill him, he brings in an insurance card. We inform the patient that because he did not provide us with the information that he will probably have to pay a penalty because we could not do a precert.
BarBara