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preauthorization

   Also found in: Wikipedia 0.01 sec.
preauthorization,
n 1. the approval of or concurrence with the treatment plan proposed by a participating dental professional before the provision of service. Under some plans, preauthorization by the carrier is required before certain services can be provided.
n 2. a statement by a third-party payer indicating that proposed treatment will be covered under the terms of the dental benefits contract. See also precertification and predetermination.

preauthorization
Managed care The requirement by an HMO that a costly surgery, specialist referral or non emergency health care services be approved by the insurer before it is allowed. See HMO.


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As her caregiver I know there is less paperwork and fewer preauthorization denials, appeals and delays than I have had with my private insurance.
A risk management information system handles the claim, a nurse ease manager system handles the preauthorization process and bill review has its own system to adjudicate bills.
Marcus Welby did not have a working wife, a computer, a preauthorization clerk in his office, or a utilization review committee in his hospital.
 
 
 
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