When Should You Get a Pre-Authorization for a Medical Interaction or Procedure?

Getting pre-authorized for medical and pharmacy services is always a good idea.

Medical care and treatment can be very expensive, which is why millions of Americans seek some form of health insurance to help cover the cost of these hefty bills. Millions of Americans, though, have found that health sharing ministries offer a great alternative to traditional insurance in the way of more affordable medical and prescription benefits.

Whether you have traditional insurance, or you are part of a health share program, when you are considering a medical service or procedure, you should ask your provider to request pre-authorization for the service.

Why Insurance Companies Require Pre-Authorization

Most health insurance providers use the process of pre-authorization to determine whether a medical service, treatment, procedure or medication is covered. The purpose of this is to ensure patient safety.

For instance, a health insurance company will want to verify that a certain medication, procedure, or service is actually required prior to a drug being prescribed or procedure being performed.

But having a medical procedure pre-authorized first is also essential for your wallet. If you go through with a procedure before your health insurance provider deems It eligible, you could be stuck having to pay the entire bill out-of-pocket.

In fact, the majority of claim denials occur when a patient is not eligible for certain medical services billed by a health care practitioner. In turn, failure to get a pre-authorization can lead to reduced payments to your medical provider, leaving you to foot the bill.

Pre-authorizations help ensure that a medical procedure or drug is safe for you.

Why Health Sharing Programs Encourage Pre-Authorizations

This may also be the case if you are a member of a health sharing ministry. While health share programs are not health insurance, they offer medical and prescription services and benefits to members much like insurance plans do.

Your health sharing ministry will want to have the chance to determine whether the procedure you are considering or the medication you are prescribed is safe and appropriate. Pre-authorization helps to ensure your safety.

Further, pre-authorization will also help your health sharing ministry prepare the appropriate payment to your medical provider. You can ensure a faster payment from your health sharing program by getting pre-authorization before receiving services. Wherever possible, you are encouraged to get pre-authorizations for each medical Interaction and procedure.

Why Choose Health Sharing Programs

Health sharing programs are a great way that two million plus American families are saving money while accessing the healthcare they need. UHSM offers a variety of health share programs with medical and prescription benefits to meet the medical and financial needs of members.

In addition, health sharing programs offer more flexibility with types of physicians you see, all while allowing you to be part of a community of like-minded people with a similar belief system. Learn more about how UHSM health share programs work – get in touch with an expert at UHSM today!

Click here to see how much you can save with a UHSM health share program.