What is insurance precertification?

Insurance precertification is the process of obtaining approval from a health insurance company before a patient receives certain medical procedures, tests, or medications. This step ensures that the insurance provider agrees the proposed service is medically necessary and will be covered under the patient’s plan. Without precertification, an insurance company may deny payment for the service, leaving the patient responsible for the full cost. The process typically involves submitting clinical information and documentation to justify the need for the service. Precertification helps manage healthcare costs and ensures appropriate care from the start.