A prior authorization determination refers to the decision made by a health insurance company regarding whether to approve or deny a request for coverage of a specific medical service, procedure, or medication. This determination is based on factors such as medical necessity, coverage policies, and clinical guidelines.
The Prior Auth Regulation Clock Is Running: What Providers Must Fix Now
Join Valer’s webinar to learn what provider organizations must fix now to modernize prior authorization workflows under CMS-0057-F and WISeR, improve compliance, and reduce delays.
