Obtaining prior authorization is a complex process that involves our medical team working with doctors contracted by your insurance to determine your eligibility for certain diagnostic imaging, medications, procedures, or referrals. The determination is based on your insurance benefits/coverage, and the medical necessity based on guidelines provided by your insurance and documentation we submit.
The following is a short list to demonstrate what typically needs a prior authorization:
- Imaging: CT scan, MRI
- Procedures: Biopsy
- Medication: Any medication that is not in covered by your insurance coverage