What term describes Authorization or approval for payment from a third-party payer requested in advance of a specific procedure?

What term describes Authorization or approval for payment from a third-party payer requested in advance of a specific procedure?

• A. Pre-authorization
• B. Premium payment
• C. Pre-certification
• D. Deductible

Answer: (A)

Prior authorization ensures the payer approves payment for a service before it’s performed. This step confirms coverage and medical necessity so the provider can proceed knowing the procedure will be paid (subject to the plan’s benefits). That pre-approval is the term described: you request authorization in advance of the specific procedure to secure payment. Premium payment is simply the ongoing fee paid to maintain the insurance plan. A deductible is the amount the patient must pay out of pocket before benefits kick in. Pre-certification is closely related and sometimes used interchangeably, but the description here specifically matches the process of obtaining authorization for payment in advance, which is pre-authorization.

Prior authorization ensures the payer approves payment for a service before it’s performed. This step confirms coverage and medical necessity so the provider can proceed knowing the procedure will be paid (subject to the plan’s benefits). That pre-approval is the term described: you request authorization in advance of the specific procedure to secure payment.

Premium payment is simply the ongoing fee paid to maintain the insurance plan. A deductible is the amount the patient must pay out of pocket before benefits kick in. Pre-certification is closely related and sometimes used interchangeably, but the description here specifically matches the process of obtaining authorization for payment in advance, which is pre-authorization.