What are 'prior authorizations' in health insurance?

Prior authorizations in health insurance refer to the requirement for insurance companies to approve certain medical services, treatments, or medications before the costs will be covered. This process is designed to ensure that the requested services are medically necessary and meet the insurer's guidelines for coverage. It involves healthcare providers submitting detailed information about the patient's condition and the proposed treatment to the insurance company. The insurer then evaluates this information and decides whether to grant approval for the service.

This process helps manage healthcare costs and ensures that patients receive appropriate and efficient care. Since prior authorization is focused specifically on critical healthcare services and treatments, it distinguishes itself from discounts, meetings, or policy notifications, which relate to different aspects of health insurance.