Is prior authorization needed from Medicaid when a patient needs immediate surgery? Explain your answer
Homework Answers
Ans) Ideally in an emergency, pre authorization won't be rewrequi but it depends:
- If you are going to be admitted to the hospital, or if you are planning any type of surgery, medical procedure, or treatment, you might want to call your insurer to make sure it does not require prior authorization.
- If it does require prior authorization, then doctor will need to contact the insurance company to explain why the surgery, procedure, treatment, or admission is necessary. That is often the only way it can be sure that insurance will cover it.
- The rules of prior authorization do not typically apply to emergencies, but there could be disagreement on what defines an emergency. If there’s any doubt, it’s a good idea to call them as soon as possible to find out about coverage.
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Is
prior authorization needed from Medicaid when a patient needs
immediate surgery? Explain your answer
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