Medical Authorization is when a service prescribed by the physician is not covered by the patient’s insurance company, the PCP must obtain medical authorization. The physician needs to contact the insurance company or fill in the required forms to explain why the prescribed service is required and the supporting clinical factors.
How to Prepare Your Prior Authorization Workflows for CMS-0057-F and Beyond
Our practical checklist and workflow mapping guide helps patient access leaders assess and organize their prior authorization processes before CMS-0057-F’s FHIR-based API requirements take effect in 2027.
