Definitions
Health Insurance Terms
Pre-Authorization

Pre-Authorization

Definition:

If a physician wants to perform a surgery, order a medical supply, or refer the patient to a specialist an authorization and approval by the health plan is usually required.

Application:

Authorization requirements manage utilization of services. Not obtaining an authorization where one may be required by the health plan will cause the payment to be reduced or be completely denied.

Definition Categories

Want to learn more? Schedule a Consultation

Get started and schedule a no cost consultation with the Business Benefits Team to learn how your business can better manage your employee benefits.

Get Started