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What is a pre authorization request?

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.

Why does it take so long for a prior authorization?

Taking into consideration the complexity of a prior authorization request, the prior authorization process selected by a healthcare provider, requirements set out in individual health plans, and any subsequent appeals process, a prior authorization (PA) can take anywhere from same day to over a month to process.

Is it difficult to get prior authorization?

The prior authorization process is often complicated by a combination of factors, including: Lots of required steps, each introducing the potential for delays and errors.

How do you initiate prior authorization?

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 if the healthcare you need is likely to require this extra step.

What is a letter of prior authorization?

Patients may wait days, weeks or even months for a necessary test or medical procedure to be scheduled because physicians need to first obtain similar authorization from an insurer. This tactic, used by insurance companies to control costs, is called prior authorization.

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