Uncategorized Archives – Academic HealthPlans
 

What is Prior-Authorization & Why do Insurance Companies Require it?

Administrators, Claims, Costs and Coverage, Uncategorized

“This procedure/medication will require prior-authorization.” Words that no patient wants to hear when they are ready to proceed with a doctor-approved treatment plan for their medical concerns. However, it is one of the utilization management tools that insurance companies have developed to determine whether certain prescribed procedures, services, and medications are medically necessary, or whether there is an equally effective treatment available to the patient.

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