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Whos Responsible for Getting the Prior Authorization? Sometimes, your health care provider will start and coordinate the prior authorization process for you. However, you may be responsible for getting the prior authorization yourself.
Prior authorization is a time-consuming, labor-intensive, and often frustrating process. Requests require several steps, and theres often a lot of back and forth with payers, especially if the initial request isnt accurate and complete.
The patient or their representative can contact their insurance company and provide the relevant information to start the Prior Authorization process. Its best to confirm with the healthcare provider if they have the information and are willing to submit the request.
Some plans allow patients to file their own prior authorizations, but most often this is a process that must be initiated with the doctors office. Often your doctor will have an idea that the healthcare you need is likely to require this extra step.
Use the Precertification Lookup Tool accessed through Payer Spaces in Availity. Call Provider Services at 1-844-421-5662.
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