Prior Authorization
Prior authorization is a requirement from a health insurance company that a provider must obtain approval before performing a specific procedure, test, or prescribing certain medications.
Definition
Prior authorization is a requirement from a health insurance company that a provider must obtain approval before performing a specific procedure, test, or prescribing certain medications.
In-Depth
What You Need to Know
Prior authorization (also called pre-authorization or pre-certification) is one of the most time-consuming administrative tasks in healthcare. Insurers use it as a cost-control measure to ensure services are medically necessary. The process typically involves the provider submitting clinical documentation to the insurer, who then reviews and either approves, denies, or requests additional information. Common services requiring prior authorization include advanced imaging (MRI, CT), specialty medications, surgical procedures, durable medical equipment, and certain specialist referrals. The process can take days to weeks and is a leading cause of treatment delays.
Calls & Questions
What Patients Ask
Common phone questions about prior authorization — and how Front Desk handles scheduling and call routing automatically.
Common Patient Questions
- 1Why do I need prior authorization?
- 2How long does prior authorization take?
- 3What happens if prior authorization is denied?
- 4Can I start treatment while waiting for authorization?
How Front Desk Helps Your Practice
Front Desk explains the prior authorization process, sets expectations for timeline, notes that the practice will handle the submission, and schedules the appointment pending authorization.
Try it freeRelated Terms
Learn More
Explore related medical terms in our glossary.
Browse Medical
More Medical Terms
Explore all medical terms in our glossary.
FAQ
Frequently Asked Questions
Common questions about prior authorization.
Prior authorization is a requirement from a health insurance company that a provider must obtain approval before performing a specific procedure, test, or prescribing certain medications. Prior authorization (also called pre-authorization or pre-certification) is one of the most time-consuming administrative tasks in healthcare. Insurers use it as a cost-control measure to ensure services are medically necessary.
Your medical provider can answer this during your appointment. Front Desk explains the prior authorization process, sets expectations for timeline, notes that the practice will handle the submission, and schedules the appointment pending authorization.
Your medical provider can answer this during your appointment. Front Desk explains the prior authorization process, sets expectations for timeline, notes that the practice will handle the submission, and schedules the appointment pending authorization.
Your medical provider can answer this during your appointment. Front Desk explains the prior authorization process, sets expectations for timeline, notes that the practice will handle the submission, and schedules the appointment pending authorization.
Ready to never miss a call again?
Stop losing revenue to busy signals. Turn every missed call into a booked appointment, 24/7.
Setup in 10 minutes•Cancel anytime