Prior Auth 101
Prior Authorization Explained
Prior authorization is your insurance company's approval — required before certain procedures, imaging, or medications will be covered. Without it, the claim is usually denied even if the care was medically necessary.
When it's required
Common: MRIs, CT scans, non-emergency surgeries, specialty medications, physical therapy beyond a limit, and out-of-network specialists.
Retro authorization
If the service already happened without prior auth, you can request retro authorization — most insurers allow it within a limited window.
Peer-to-peer review
If auth is denied, your doctor can request a peer-to-peer call with the insurer's medical reviewer. This overturns many denials.
“Wait for the Lord; be strong, and let your heart take courage; wait for the Lord!”
Scripture is offered for encouragement and reflection and is not a substitute for professional medical, legal, financial, or healthcare advice.