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Pre-Authorization Explained

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Preauthorization (sometimes called prior auth) is when your doctor must get approval from your insurance company before proceeding with certain treatments, tests, or medications. It’s typically required for complex procedures but can apply to almost any healthcare service. The process involves your doctor submitting a request, the insurance reviewing it, and then either approving or denying coverage. Insurance companies require prior auth to control costs, promote safer options, prevent unnecessary procedures, and reduce overuse of services. While it can be frustrating, it’s important to work with your doctor to find the best approach, whether pushing for approval or appealing a denial.

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