Preauthorization

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Preauthorization

Preauthorization (pronunciation: pre-aw-thor-iz-ay-shun), also known as prior authorization, is a process used by health insurance companies to determine if they will cover a prescribed procedure, service, or medication. The decision is based on the insurance coverage policy and medical necessity.

Etymology

The term "preauthorization" is derived from the prefix "pre-" meaning "before", and "authorization", which means "the action of authorizing". In the context of healthcare, it refers to the approval granted by an insurance company before a healthcare service is provided.

Related Terms

  • Health Insurance: A type of insurance coverage that pays for medical and surgical expenses incurred by the insured.
  • Medical Necessity: A legal concept related to health insurance, where treatments are covered only if they are deemed necessary for the patient's health.
  • Insurance Coverage Policy: A contract detailing the terms and conditions of an insurance coverage.
  • Prescribed Procedure: A medical procedure recommended by a healthcare professional.
  • Service: In healthcare, a type of support or care given to improve a person's health.
  • Medication: Substances used to diagnose, treat, or prevent disease.

See Also

External links

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