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Glossary

What Is Prior Authorization?

Prior authorization is an insurer’s approval, required before certain treatments, tests or medications, confirming that the plan will cover them.

If a service that needs approval is delivered without it, the claim is often denied, even when the care was appropriate. Practices therefore check authorization requirements when they book the visit.

The process is paperwork-heavy: submitting clinical information, tracking the request and following up with the payer, which is why many practices delegate it to a dedicated team.

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