Pre-certification, also known as prior-authorization or prior approval, occurs before care is rendered. A decision by your health insurer or plan that a health care service, treatment plan, prescription drug or durable medical equipment is medically necessary. A request for authorization must be set forth on the prescribed form or format by your insurer along with the required information for Utilization Review Department at insurance to make a decision whether the medical treatment or services requested is medical necessary or not.
MedCare offers this much needed service for insurance authorization as a part of the complete RCM Solutions Package.
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