Domain: EnrollEligCOB — EnrollEligCOB
PriorAuthorization
PriorAuthorization
EnrollEligCOB::PriorAuthorization
Prior authorization is a requirement that a prescribing physician obtain approval from the patient's health plan to prescribe a specific medication. Without this prior approval, the patient's health plan may not provide coverage, or pay for, the medication. This class contains information concerning a prior authorization already issued by a payer so that (among other reasons) the pharmacy would be aware of the prior authorization and may cite the prior authorization details to the payer on a claim in order to ensure that the payer recognizes the claim as authorized and therefore improves the chances of payment.
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