Definitions for "Pre-certification"
A process used by health insurance providers whereby the patient informs the provider that a particular procedure or drug to treat a disease has been ordered by a physician. Once the procedure or drug has been pre-certified, the provider will pay for the cost of the procedure or therapy.
Requirement to receive prior approval for hospital admission and certain other services. Feature of many managed care health plans
this is when you or your healthcare provider review your planned medical care with your insurance company. This helps clarify your benefits and what the insurance company will pay for.
A third-party payer's confirmation of a patient's eligibility for coverage under a benefit program.
The prior authorization required by some managed care companies before health benefit payments will be authorized. See "Authorization."
Authorization in advance of medical services.
See 'Pre-Authorization'
The process of obtaining permission to perform a service form the insurance carrier before the service is performed.