clinical workflows

How Prior Authorization Impacts Care, Cost, and Clinical Workflows?

Prior Authorization (PA) also known as pre-authorization or pre-certification is a process required by many health insurance companies to approve specific medications, medical procedures, tests, or durable medical equipment (DME) before they are provided. It’s a method used to ensure treatments are medically necessary and cost-effective. While Prior Authorization is often viewed as a hurdle, it also plays a role in helping patients access expensive but necessary services and specialty drugs. It may also help avoid unnecessary hospital stays by