Common use of Preauthorization Clause in Contracts

Preauthorization. The Health Services listed below do not require Preauthorization. (A) Emergency Services. (B) Preventive Services provided by a Participating Provider. A Provider that provides [You][an Enrollee] with Emergency Services may not charge You except for an applicable Copay or Deductible. All other Health Services must be made through Your PMP. [Your][An Enrollee’s] PMP will determine whether Preauthorization is required. The following is a list of Health Services that require Preauthorization. This list is not exhaustive. (A) Elective/Urgent Inpatient Admissions.

Preauthorization. The Health Services listed below do not require Preauthorization. (A) Emergency Services. (B) Preventive Services provided by a Participating Provider. A Provider that provides [You][an Enrollee] with Emergency Services may not charge You except for an applicable Copay or Deductible. All other Health Services must be made through Your PMP. [Your][An Enrollee’s] PMP will determine whether Preauthorization is required. The following is a list of Health Services that require Preauthorization. This list is not exhaustive. (A) Elective/Urgent Inpatient Admissions.