What Is Prior Authorization?

Prior authorization (also known as pre-authorization or pre-approval) is a decision by your health insurer or plan that a health care service, treatment plan, prescription drug, or durable medical equipment is medically necessary. It is an approval that is required before you receive the service.

Why It's Required

• Your health plan requires it for certain services to control costs and ensure the treatment is appropriate.
• Without prior authorization, your insurance may not pay for the service, leaving you with a large bill.

How Mira Mace Can Help

Dealing with prior authorization delays and denials is one of the most common and frustrating parts of healthcare. Our advocates are experts at managing this process. We follow up with your doctor's office and insurance company to expedite approvals and appeal denials on your behalf.