Prior Authorization

What Does Prior Authorization Mean?

Prior authorization is the approval granted by a health insurer or third party for a healthcare service or prescription before the patient receives it. This process ensures that only covered expenses are billed to the insurer.

Insuranceopedia Explains Prior Authorization

When a pharmacy receives a prescription, it often verifies that prior authorization has been granted by the insurance company. If prior authorization is not obtained, the pharmacy may decline to fill the prescription and provide it to the patient.