A decision by your health insurer or plan that a health care service, treatment plan, prescription drug or durable medical equipment is medically necessary.
Insurance companies make this confusing by using several terms that mean the same.
• Sometimes called precertification, prior approval or preauthorization.
Your health insurance or plan may require prior authorization for certain services before you receive them, except in an emergency.
♦ Prior authorization isn’t a promise your health insurance will cover the cost.
• Why do I need it ?
• What if prior authorization is denied ?