What Is Pre-Authorization And How Can It Cost You Money?

November 9, 2010 | Posted by Ethan Kalvin

Pre-authorization is something that your health insurance uses as a hoop for you to jump through in order to receive your benefits. But why do they do it? Well, honestly because they want to examine the thought process behind the treatment while also requiring a little more forethought about procedures prior to having them done.

Pre-authorization may be used to deny claims because if you are required to obtain prior authorization for treatment and you do not have health insurance company may say that you have not met the criteria for have covered this procedure and therefore you expect to pay for that on the procedure of your own pocket. When you look at your health insurance policy, it is important to understand when you will be required to obtain pre-authorization of health care that can vary from one policy to the.

Now, prior authorizations can really help you, especially if you go to a provider network in the case of an HMO or PPO plan. outside suppliers should contact your insurance company with a treatment plan before you finish something beyond a routine visit. Although it seems to take some time and be a problem having this information will allow you to make informed choices about your health.

Once you look at the EOB sent by your health insurance company, you will be able to see exactly what they cover and the total amount of pocket as you are responsible. This will help you plan financially for your treatment and if the cost seems to be on top then you’ll probably have to choose a network service provider to complete your treatment as usual this will result in a much smaller load pocket for you. It is important to realize certain plans with the doctor you choose is equally important that the treatment you receive.

The pre-authorizations that are required by your health insurance company can hurt you financially if you are not aware of them so it is important to take time and find out when and where you need to contact your health insurance company before treatment. Making that call is a simple thing, but it can help save you from the risk of a large medical bill at the end and may allow you peace of mind in knowing that you are having the procedure done will be covered by the insurance company.

Be careful with any future changes to your health insurance. It is smart to understand what is happening with Health Insurance plans that will affect you directly.