Prior Authorization in Medical Billing: Definition and Process
Prior authorization is a payer requirement to approve services before they are provided. Learn how it works, what requires PA.
Prior Authorization at a Glance
Prior authorization is a payer pre-approval requirement for specific services, procedures, or medications before they are provided, managed proactively through prior authorization services.
- Missing or incorrect PA is a leading cause of preventable denials escalated to denial management.
- Return to the full medical billing glossary for related terms.
PRIOR-AUTHORIZATION in Detail
What does PRIOR-AUTHORIZATION cover in detail?
Prior authorization is a payer pre-approval requirement for specific services, procedures, or medications before they are provided, managed proactively through prior authorization services.
Missing or incorrect PA is a leading cause of preventable denials escalated to denial management. Return to the full medical billing glossary for related terms.
Using PRIOR-AUTHORIZATION Correctly
How do I use PRIOR-AUTHORIZATION correctly?
Definition in Practice
Prior authorization is a payer requirement to approve services before they are provided. Learn how it works, what requires PA.
Billing Impact
This concept directly affects how claims are prepared, submitted, and adjudicated. Errors related to this term are a common source of denials.
Documentation Relevance
Clinical documentation accuracy related to this concept determines whether claims are paid, reduced, or denied on the first submission.
Related Concepts
Understanding this term builds a foundation for understanding the broader revenue cycle. Review related terms and processes to build comprehensive knowledge.
Related Billing Resources
PRIOR-AUTHORIZATION, Frequently Asked Questions
Prior authorization is a payer pre-approval requirement for specific services, procedures, or medications before they are provided, managed proactively through prior authorization services.
Missing or incorrect PA is a leading cause of preventable denials escalated to denial management. Return to the full medical billing glossary for related terms.
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