What does prior authorization involve?

Prior authorization involves the requirement for healthcare providers to obtain approval from a health insurance company before prescribing certain medications or treatments, particularly those that are high-cost or require special consideration. This process ensures that the medication is medically necessary and meets the insurance plan's guidelines for coverage.

Choosing approval for expensive medications as the correct answer highlights the specific nature of prior authorization. Many insurance plans use this mechanism to manage costs and ensure appropriate utilization of high-priced treatments. This process typically includes a review of the patient's medical history and the justification for the medication to ensure it aligns with coverage policies.

In contrast, mandatory insurance review, eligibility confirmation, and claim dispute resolution each refer to different aspects of the healthcare and insurance process. While they are essential, they do not encapsulate the specific role of prior authorization in controlling access to certain medications.