Describe the term "pre-authorization" in health insurance.

Describe the term "pre-authorization" in health insurance.

• A. A mandatory payment before treatments
• B. An approval requirement for certain services
• C. A type of health policy
• D. A free consultation service

Answer: (B)

Pre-authorization refers to the requirement set by a health insurance provider that certain medical services, procedures, or medications must be approved prior to being provided to the patient. This process is in place to ensure that the treatment is medically necessary and covered under the patient's insurance plan. When a healthcare provider seeks pre-authorization, they submit details about the proposed treatment to the insurer. The insurer then reviews the information and determines whether to approve or deny the request based on the patient's specific policy details, the medical necessity of the treatment, and other factors. This step helps control healthcare costs and ensure that patients receive appropriate care.

Pre-authorization refers to the requirement set by a health insurance provider that certain medical services, procedures, or medications must be approved prior to being provided to the patient. This process is in place to ensure that the treatment is medically necessary and covered under the patient's insurance plan.

When a healthcare provider seeks pre-authorization, they submit details about the proposed treatment to the insurer. The insurer then reviews the information and determines whether to approve or deny the request based on the patient's specific policy details, the medical necessity of the treatment, and other factors. This step helps control healthcare costs and ensure that patients receive appropriate care.