This post was reviewed by our Director of Clinical Excellence and Oversight.
If you’ve received medical care and have insurance, you’ve probably heard of insurance preauthorization. It can be a necessary step in getting the supplies or treatment you need to be covered by your insurance plan. But it can also be confusing. What is insurance preauthorization and how does it affect people who need medical supplies? Get the answers to these questions and more below.
What is preauthorization?
Preauthorization, sometimes call pre-certification, predetermination, or prior-approval, is a requirement from an insurance plan to authorize a healthcare service or product before it is provided. That means the insurance plan approves of medical supplies before treatment or supplies are provided.
Why do I need preauthorization?
Preauthorization allows insurance plans to review supplies or services to help make sure you are receiving the right products for your needs. During preauthorization, reviewers confirm that the requested supplies are needed to treat your specific medical condition and that you’re receiving the correct quantity. This is also important for you, since you will have a better idea of what is covered or not covered, which could potentially leave you with the responsibility of covering the cost.
When do I need preauthorization?
Preauthorization requirements are different for every insurance plan and condition. Whether or not you need preauthorization to receive supplies can depend on a few factors, including:
- The insurance plan type
- Coverage requirements
- Type of supplies
If you use Home Care Delivered to receive your medical supplies, you don’t have to worry about finding out if a preauthorization is needed. We keep track of each insurance plan’s specific requirements so you don’t have to. If you need preauthorization for your supplies, we’ll always let you know, and also retrieve it for you.
How do I get a preauthorization?
If you’re an HCD customer, you don’t have to! We take care of the paperwork on your behalf, including preauthorizations. If you need a preauthorization from your insurance plan, we’ll collect all the necessary paperwork from your doctor and send it to your insurance plan for approval. After we receive the completed preauthorization, we’ll ship your supplies.
Taking care of preauthorizations is just one of the many things HCD does to take the stress out of receiving medical supplies. If you’d like to sign up for supply deliveries, enter your phone number in the bottom left of this screen and we’ll give you a call. When you do, you’ll experience for yourself why we’re the highest-rated medical supplier.