Pre-Authorization (AKA Prior Auth)

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In this video, we further unpack the concept of Pre-Authorization or Prior Auth in healthcare:

  • Preauthorization, also known as "prior auth" or "pre-approval," is a process that involves seeking permission from your insurance provider before you can receive certain medical treatments, tests, or medications.

  • It is typically required for more complex and potentially costly treatments, surgeries, and prescriptions.

  • Some examples of when preauthorization might be necessary are: medications that are unsafe in combination with others, procedures with lower-cost alternatives, and treatments or medications that are frequently misused or abused. Please note that this list is not exhaustive.

  • While preauthorization can seem frustrating, it serves the purpose of ensuring that the medical service or prescription is medically necessary, safe, and prevents potential complications, thereby helping manage healthcare costs effectively.