Definitions for "Precertification"
A utilization management program that requires the insured or the health care provider to notify the insurer prior to a hospitalization or surgical procedure. The notification allows the insurer to authorize payment, as well as to recommend alternate courses of action
A method of providing assurance to the employee or provider that the admission to an institution is a covered benefit. In addition, precertificiation provides information as to the approved length of coverage. Traditionally, this type of review is used for hospital inpatient admissions.
Review processes that verifies the medical necessity and appropriateness of proposed services or supplies.
Confirmation by a third-party payer of a patient's eligibility for coverage under a dental benefit program.
Clinicians must request permission to provide services to patients before instigating treatment
See preadmission certification.
Keywords:  predetermination, see
See Predetermination.
Keywords:  prior, authorization, see
See Authorization and Prior authorization.