Requirement imposed by a third party, under some systems of utilization review, that a provider must justify before a peer review committee, insurance company representative, or State agent the need for delivering a particular service to a patient before actually providing the service in order to receive reimbursement. Generally, prior authorization is required for non-emergency services which are expensive (involving a hospital stay, preadmission certification, for example) or particularly likely to be overused or abused (many State Medicaid programs require prior authorization of all dental services, for instance).<\/p>\n
The approval by an insurer or other third-party payor of a health care service before the service is rendered. This approval is required in order for the insurer to pay the provider for the service.<\/p>\n
<\/p>\n","protected":false},"excerpt":{"rendered":"
Requirement imposed by a third party, under some systems of utilization review, that a provider must justify before a peer review committee, insurance company representative, or State agent the need for delivering a particular service to a patient before actually providing the service in order to receive reimbursement. Generally, prior authorization is required for non-emergency […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[16],"tags":[],"class_list":["post-81680","post","type-post","status-publish","format-standard","hentry","category-p"],"yoast_head":"\n