Prior authorization definition

Prior authorization means that we must approve the Services in advance in order for the Services to be covered.

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Prior authorization means approval for the provision of a service or the delivery of goods from the department before the provider actually provides the service or delivers the goods;

Prior authorization means a decision by ▇▇▇▇▇, prior to the time a Health Care Service or other benefit is to be delivered, that the Health Care Services are Medically Necessary. Prior Authorization is sometimes called pre-authorization, prior approval or pre-certification. AvMed requires you or your Physician to obtain Prior Authorization for certain services and medications before you receive them to ensure that you receive the most appropriate treatment. Prior Authorization is not a promise that AvMed will cover the cost of such services or medications.

Examples of Prior authorization in a sentence

• Prior authorization in writing by COUNTY’s Contract Administrator shall be required before CONSULTANT enters into any unbudgeted purchase order, or subcontract exceeding five thousand dollars ($5,000) for supplies, equipment, or CONSULTANT services.

• Prior authorization is prohibited for non-residential DMC-ODS services.

• In the event the Agency office or work site is closed, affected bargaining unit consultants with a legitimate reason to work that day due to impending deadlines or scheduled conferences must request authorization from their supervisor before 8:00 a.m. Prior authorization from the supervisor is required.

• Prior authorization must be received before utilization of floating holidays.

• Prior authorization in writing by the CALTRANS Contract Manager shall be required before $500 for supplies, equipment, or consultant services.

More Definitions of Prior authorization

Prior authorization means a process implemented by the department of community health that conditions, delays, or denies the delivery of particular pharmaceutical services to medicaid beneficiaries upon application of predetermined criteria by the department or the department's agent for those pharmaceutical services covered by the department on a fee-for-service basis or pursuant to a contract for those services. The process may require a prescriber to verify with the department or the department's agent that the proposed medical use of a prescription drug being prescribed for a patient meets the predetermined criteria for a prescription drug that is otherwise covered under this act or require a prescriber to obtain authorization from the department or the department's agent before prescribing or dispensing a prescription drug that is not included on a preferred drug list or that is subject to special access or reimbursement restrictions.

Prior authorization or “Prior Authorized” means a system that requires a Provider to get approval from the CO-OP before providing non-emergency healthcare services to a Member for those services to be considered Covered Services. Prior Authorization is not an agreement to pay for a service.

Prior authorization means the local Aging and People with Disabilities or Area Agency on Aging office participates in the development of proposed nursing facility care plans to assure the facility is the most suitable service setting for the individual. Nursing facility reimbursement is contingent upon prior-authorization.

Prior authorization or “Prior Authorized” means a system that requires a Provider to get approval from SHL before providing non-emergency healthcare services to an Insured for those services to be considered Covered Services. Prior Authorization is not an agreement to pay for a service.

Prior authorization means a function performed by EGID, or its designee, to review for medical necessity in identified areas of practice as defined at 7.1 of this Contract, prior to services being rendered.

Prior authorization means the process of obtaining prior approval as to the appropriateness of a service or medication. Prior authorization does not guarantee coverage.

Prior authorization means the approval process used by a carrier before certain drug benefits may