Insurance and billing
Pre-authorization
Also called prior authorization, prior approval, precertification
A request to the insurer for approval of a planned service before it is done; approval is not a payment guarantee.
Pre-authorization means asking an insurer to approve a planned treatment before it happens. Some plans require it for certain services, and an office typically sends X-rays, notes and a description of the work. Approval says the plan agrees the service is needed, but it does not promise payment, which still depends on eligibility, limits and benefits at the time of treatment. Tell patients this plainly before they book.
Example at the front desk
The plan requires pre-authorization for the implant, so I sent the request with the X-rays and chart notes.
US and Canada
In Canada, the Canadian Dental Care Plan uses preauthorization for certain services. In the US, whether it is required depends on the individual plan.