common prior authorization issues

Common Reasons Prior Authorization Gets Denied in Healthcare

Prior authorization (PA) serves as a checkpoint in healthcare to ensure that services, procedures, and medications meet an insurance plan’s coverage and necessity standards. However, prior authorization denials remain a persistent challenge, delaying patient care and creating administrative burdens. Understanding the common reasons behind these denials is essential for healthcare providers and patients alike.  Incomplete or Missing Information Insurance companies require comprehensive documentation to review a prior authorization request. Missing medical records, inadequate physician notes, lack of relevant lab results,