What does the term "pre-authorization" refer to?

The term "pre-authorization" specifically refers to the process by which an insurance company grants approval for a patient to receive a certain service or treatment before it occurs. This process typically involves the healthcare provider submitting information regarding the patient's condition and the proposed treatment to the insurer. This ensures that the planned service aligns with the insurance policy's terms and conditions and can help avoid unexpected costs for the patient. By obtaining pre-authorization, healthcare providers and patients can ensure that the insurance will cover the costs associated with the treatment, thus facilitating better financial planning and care delivery.

Other terms that might seem related, such as requiring upfront payments or summarizing medical histories, do not capture the essence of the pre-authorization process, which focuses specifically on obtaining consent or approval from the insurance entity for a procedure.