Prior authorization means that a doctor must contact your insurance before providing certain medical treatments. This ensures that the doctor and the insurer agree that the treatment is “medically necessary.” Prior authorization reduces the risk that the insurer will deny the claim, which is the request for payment after you receive medical care.
References
Healthcare Marketplace. (n.d.). Preauthorization.
Insureanceopedia. (2023). What does prior authorization mean?
Patient Advocate Foundation. (n.d.). What does an approved pre-authorization mean?
Why trust our experts?
Written by:
Hilary WeissmanHilary Weissman has been a health writer for the past 6 years. She was a senior copywriter at WW (Weight Watchers) before joining GoodRx and was also a copy editor in S&P Global’s structured finance ratings group for 3 years prior.
Reviewed by:
Brian Clista, MDDr. Clista is a board-certified pediatrician who works in private practice in Pittsburgh, Pennsylvania. He previously served as a National Health Service Corporation Scholar in the inner city of Pittsburgh for 11 years.
