Prior authorization request definition
Prior authorization request means a request for pre-approval from an insurer for a specified prescription or quantity of a prescription before the prescription is dispensed.
Prior authorization request means a Service Authorization Request by the Enrollee, or a provider on the Enrollee’s behalf, for coverage of a new service, whether for a new authorization period or within an existing authorization period, before such service is provided to the Enrollee.
Prior authorization request means a method by which practitioners seek approval from Contractor to render medical services. The Contractor's Utilization Review (UR) Coordinator is responsible for granting approval to providing specific, non-emergency medical services in advance of rendering such services.