What is preauthorization?
Preauthorization is the process by which a health care company or preauthorization company reviews the proposed treatment and tells you and your doctor how benefits may be paid. If you receive care out-of-network, you must obtain preauthorization for certain covered expenses such as a hospital stay. Some plans also require preauthorization for certain in-network services. If you don’t get the required preauthorization, your cost will be higher because the benefits payable by the plan will be reduced or the expenses will not be covered at all.