Josie’s doctor needs to give clinical information specific to the treatment requested to establish medical necessity,
Prior authorization (or PA) is a management process used by insurance companies to determine whether or not a prescribed product or service will be covered.
This indicates whether the product or service will be paid in full or in part. This procedure can be used before administering medications, procedures, or services to patients.
The general process has many names including precertification, pre-authorization, prior approval, and predetermination.
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