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Prior authorization is also known as precertification, predetermination, and pre-approval. Without prior approval , your health insurance plan may not pay for your treatment (even if it would otherwise be covered by the plan), leaving you responsible for the full bill.
The meaning of PRE-AUTHORIZATION is prior authorization; especially : authorization (as by an insurer) that is required prior to performance of a health care service (such as a surgery or prescription of a drug). How to use pre-authorization in a sentence.
Prior authorization is a health plan cost-control process that requires physicians and other health care professionals to obtain advance approval from a health plan before a specific service is delivered to the patient to qualify for payment coverage.
A decision by your health insurer or plan that a health care service, treatment plan, prescription drug or durable medical equipment is medically necessary. Sometimes called prior authorization, prior approval or precertification.
Prior authorization, also known as pre-authorization or pre-certification, allows health insurance plans to review proposed care ahead of time, confirm that coverage for the service is available under the plan, and give the medical provider approval to go ahead with the procedure or prescription.
Prior authorization is the approval from your health insurance that may be required for a service, treatment, or prescription to be covered by your plan if it's not an emergency. Prior authorization does not guarantee payment, but it does make it more likely your health plan will cover the cost.
Prior authorization is a check that your plan covers the proposed care. It’s also a way the health plan can decide if the care is medically necessary, safe, and cost effective. (Medicare Part A and Part B generally do not require prior authorization. However, Medicare Advantage and Medicare prescription drug plans (Part D) may require prior ...