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Is it difficult to get prior authorization?

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.

How to get prior authorization for insurance?

What are the steps to obtaining prior authorization? Your insurance company will review your doctors request. Once theyve decided, theyll send their decision to both you and your medical provider in writing. If your doctor feels that you cant wait that long, they can submit an urgent or expediated request.

Who is responsible for obtaining preauthorization?

Your health care provider can make the prior authorization request. If your provider submits the request, they will send the required information to your health plan. You may need to fill out forms for your providers office.

Why is it so hard to get a prior authorization?

Provider Notice, Including Denial Reason: Beginning in 2026, impacted payers must provide a specific reason for denied prior authorization decisions, regardless of the method used to send the prior authorization request. Such decisions may be communicated via portal, fax, email, mail, or phone.

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