Ask Before You Book!
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)
Pain management services
Non-emergency ambulance services
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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