INSURANCE

What is prior authorization and why does my insurer require it?

SHORT ANSWER

Prior authorization is your insurer’s advance approval for certain services, drugs, or procedures before it will pay. If required and not obtained, the claim can be denied — but a missing authorization is often fixable, and a denial of the authorization itself can be appealed.

Prior authorization is a cost-control step insurers use for specific medications, imaging, procedures, and equipment: your provider must get the insurer’s approval before the service, or the claim may be denied. It is a frequent source of surprise bills when the step is missed or the approval is denied as not meeting criteria. The good news is that both problems have paths forward — a missing authorization can sometimes be obtained retroactively, and a denied authorization can be appealed with clinical support, just like a claim denial.

What to do, in order

  1. Check whether your plan required prior authorization for the service — your provider or plan can confirm.
  2. If it was missed, ask the provider to request a retroactive authorization.
  3. If the authorization was denied, get the specific reason and a supporting note from your provider.
  4. Appeal the denial in writing before the deadline, addressing the criterion cited.
  5. Escalate to an external review if the internal appeal is unsuccessful.

Common questions

Who is responsible for getting prior authorization?

Usually your provider requests it, but the financial consequence falls on you if it is missed. It is worth confirming it was obtained before a major service.

Can a denied authorization be appealed?

Yes. Like a claim denial, a denied prior authorization can be appealed with clinical documentation, and then taken to external review if needed.

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This is general information, not legal, tax, or financial advice, and it doesn’t create a professional relationship. Rules have exceptions and change over time. For advice on your specific situation, consult a licensed professional.