Definitions for "Pre-Authorization"
Similar to pre-admission certificate, a condition of receiving health benefits. Review and approval process that must be completed before services are provided, when an inpatient or ambulatory site is proposed for care. The review process may include an assessment of the physician's proposed protocol and fees. Compliance with changes in the proposed treatment plan recommended by reviewing entity may be a condition of receiving full coverage under the health benefit.
A requirement by an insurance company or health plan that certain services must be approved in advance to be covered or to be covered without a penalty.
written acknowledgement by a health plan that the specific drug requested by a provider is medically necessary, thus providing a promise of reimbursement once that drug is administered or dispensed.
a validity check to reserve a certain amount that would guarantee the room
Method by which an amount of funds is reserved for a period of time, to await sales completion.