In plain English
This means the insurer has to agree in advance to the service. The status indicates that coverage depends on getting that approval first.
In context
Here, it reports that this service needs the insurer's approval in advance for coverage.
- Situation
- Checking provider networks, authorization, referrals, eligibility, and preapproval states
- What it communicates
- reports that the service carries an authorization requirement in the portal.
Meaning limits
By itself, this status does not say whether that approval has already been obtained.
Examples
“The follow-up scan was authorization required before the insurer would cover it, but the blood test was covered without advance approval.”
“Even with a doctor's order, outpatient therapy is authorization required for coverage under her plan.”