A requirement by insurance companies for providers to obtain approval before delivering certain services, ensuring the services are medically necessary and covered under the patient's plan.
A formal request to an insurance company to reconsider a denied claim or prior authorization decision.
The process of confirming a patient's insurance coverage, benefits, copay, deductible status, and authorization requirements before providing services.
The clinical justification that a healthcare service is reasonable and necessary for the diagnosis or treatment of a patient's condition.
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