prior authorization
Pre-approval for treatment
Prior authorization is a requirement imposed by health insurers that a patient or healthcare provider must obtain approval before a medical service, procedure, or medication will be covered.
The insurer reviews whether the proposed treatment is medically necessary and cost-effective before agreeing to pay for it.
The surgery was delayed while we waited for prior authorization from the insurance company.
Critics argue that prior authorization creates bureaucratic barriers that can delay urgent care and burden medical staff with paperwork.
- preapprovalAuthorization before final commitment
- denialRefusal to accept reality
- denied claimRequest formally refused
- insuranceContractual risk coverage
- insurance companyEntity selling risk protection
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- Health Activismhealth policy, health equity, healthcare access, patient rights, public health campaigns
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- Healthcare Administrationpatient care, patient records, billing, appointments, referrals
- healthcare problemsmedical errors, misdiagnosis, high costs, long waits, staffing shortages
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