Describe the term "pre-authorization" in health insurance.

Prepare for the Arizona Health Insurance Test. Study with flashcards and multiple choice questions, each question has hints and detailed explanations. Get ready to excel in your exam!

Pre-authorization refers to the requirement set by a health insurance provider that certain medical services, procedures, or medications must be approved prior to being provided to the patient. This process is in place to ensure that the treatment is medically necessary and covered under the patient's insurance plan.

When a healthcare provider seeks pre-authorization, they submit details about the proposed treatment to the insurer. The insurer then reviews the information and determines whether to approve or deny the request based on the patient's specific policy details, the medical necessity of the treatment, and other factors. This step helps control healthcare costs and ensure that patients receive appropriate care.

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