Which of the following terms describes when insurance companies require that specific criteria are met before they will consider paying for a patient's prescription medication?

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Prior authorization is needed when a patient's insurance company requires that the patient meets specific criteria before they will consider paying for a patient's prescription medication. The insurance company often requires the patient first try, and fail using less expensive treatment options before they will consider paying for a more expensive medication. If the patient has tried and failed the less expensive options, the doctor's office must document this, and send paperwork to the insurance company to request approval for the more expensive option.

Which of the Following Terms Describes When Insurance Companies Require