Payer policy · Definition
Prior authorization: Definition
Payer approval required before a service is performed, without which the claim is denied regardless of medical necessity.
This is a short definition only. The full explanation lives on dermatology prior authorization services, which is the page to read if you are dealing with this on live claims.
Definition
Dermatology encounters it most with biologics, phototherapy, some laser treatments and Mohs on certain plans — particularly Medicare Advantage products that impose requirements traditional Medicare does not.
Return to the dermatology billing glossary.