What You Need to Know About Prior Authorizations

Prior authorization, also known as pre-authorization or pre-certification, is an approval of coverage from your insurance company, not your doctor. It's a restriction put in place to allow health insurance companies to review proposed care ahead of time and to determine whether or not they will pay for certain medical services. It doesn't affect self pay (cash) payments for services.

• Prior authorizations are required by insurance companies for some medications. This includes those that may have less expensive alternatives. 

• The prior authorization process usually takes about 2 days. Once approved, the prior authorization lasts for a defined timeframe. 

• You may be able to speed up a prior authorization by filing an urgent request. If you can’t wait for approval, you may be able to pay upfront and submit a  reimbursement claim after approval.