Prior authorization—sometimes called pre–authorization or pre–certification—is a health plan cost-control process by which physicians and other health care providers must obtain advance approval from a health plan before a specific service is delivered to the patient to qualify for payment coverage. Prior authorization is a formal request made by the medical provider (before offering a medical service) seeking authorization from the insurance company to proceed with a medical service. Authorizations can be sought for tests, surgeries, prescriptions, and other medical services.
The Prior Auth Regulation Reality Check: Beyond the Headlines
Join Valer Co-Founder and CEO Dr. Steve Kim for an unfiltered look at what CMS-0057-F and WISeR will—and won’t—change for your patient access operations. This webinar breaks down the real-world implications behind the regulations, the gaps between policy and practice, and a practical checklist to help your team prepare for what’s next.
