Ask Before You Book!

Some healthcare services will require authorization before your insurance will agree to cover the charge. Make sure you don't get slammed with an unexpected medical bill!

Some healthcare services will require authorization before your insurance will agree to cover the charge. Make sure you don't get slammed with an unexpected medical bill!

For some healthcare services, your insurance company may require preauthorization, or prior approval, before you can receive them. Preauthorization is a decision by your health insurer that a treatment, prescription drug, or device is medically necessary. This process helps health insurance companies control costs by reducing duplication and unnecessary treatments. If you receive care without first receiving a prior approval, your insurance company might not cover your claims.

Some medical procedures that often require preauthorization are:

  • Gastrointestinal tests (colonoscopies, endoscopies, CT scans)

  • Home care/hospice

  • Pain management services

  • Radiology services

  • Sleep studies

  • Surgeries

  • Non-emergency ambulance services

  • Specialty drugs

  • Medical equipment

Since every insurance company has its own rules, you should be proactive and call your insurer to see if you need preauthorization before making an appointment. Oftentimes, your healthcare provider will be able to initiate prior approval on your behalf, but understanding your policy’s preauthorization rules can save you from receiving an unexpected bill.

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