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. Your health insurance or plan may require preauthorization for certain services before you receive them, except in an emergency. Preauthorization isn’t a promise your health insurance or plan will cover the cost.
Some insurance companies require authorization from them before they will pay for medical services like hospitalization or surgery.
- Browse Related Terms: Accreditation, Biosimilar Biological Products, Denial, Experimental and/or Investigational Medical Services, Not Yet Accredited (Health Plan), Pre-authorization, Preauthorization, Prior Authorization, Provider