What does 'prior authorization' require from healthcare providers?

'Prior authorization' is a process that mandates healthcare providers to obtain approval from insurers before delivering certain medical services or prescribing specific medications. This requirement is put in place to ensure that the proposed treatment is medically necessary and aligns with the insurer's coverage guidelines. It serves as a cost-control mechanism, allowing insurance companies to manage expenditures on healthcare services that might not be required for the patient's condition.

By requiring prior authorization, insurers can review the patient's medical history and the proposed treatment's necessity, potentially reducing unnecessary procedures and costs. Providers must submit detailed information to justify the need for the treatment, which helps to ensure that patients receive appropriate care that is both clinically and financially justified.

In contrast, the other options do not accurately reflect the nature of prior authorization. Immediate treatment without approval, comprehensive documentation of patient care, or notifying patients about treatment plans are not part of the prior authorization process. These aspects are related to regular healthcare practices but do not specifically address the authorization requirements set by insurance providers.