Reference no: EM133356489

Question

What is the step by step explanation for "Prior approval, also known as prior or pre-authorization, allows health plans to evaluate whether care or medication is medically necessary or even covered by them. They will only pay for services if you get permission from your health plan. Prior authorization typically takes about two days to be processed, but some can take up to 30 days to be approved. My experience as a patient with prior approval through Tricare Prime for Vision Care/Surgical procedures has been that it takes 30 days or a little longer for authorization to be approved, which can be frustrating.

Having an approved prior authorization would benefit my job because it would avoid wasted time and money on treatments patients do not need. In addition, it would ensure services and drugs the physician requests are indeed medically necessary."