A pre-authorization, also known as prior authorization, precertification, or prior approval, is used by insurance carriers to determine if the services being requested by your office are medically necessary for patients. Typically, a prior authorization request is sent before a service or procedure is provided to ensure proper payment when submitting a claim.

However, submitting authorization requests in advance may not always be possible, given a patient’s condition and the long turnaround time for authorization requests. In scenarios where a service provider feels that it is absolutely necessary for their patient to receive a diagnostic or procedure before authorization may be obtained, post-authorizations or retroactive authorizations may be requested.
The insurance providers who allow retro authorizations are limited but in cases where they can be obtained, the request must be submitted immediately after the service is completed to ensure approval and payment.
The Pier17 Authorizations Department is skilled in obtaining post-authorizations and retroactive authorizations and can work with you to make certain that payment for services requiring them is not lost. If you’re looking for professional help, contact us today!
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