Prior Authorization
Definition
A requirement by your insurance company to approve a medical service, procedure, or prescription before it's performed. Without prior auth, the insurer may deny the claim entirely, leaving you responsible for the full cost.
Why It Matters
Prior auth denials are the #1 cause of unexpected medical bills. Knowing whether your procedure requires prior auth — and confirming approval before the appointment — prevents surprise bills of $5,000 to $50,000+.
In Your Records
Tabula Medica flags procedures and medications in your records that commonly require prior authorization. When your doctor orders an MRI, the AI alerts you to check with your insurer first.
FHIR Resource Type
This data appears in your records as a FHIR CoverageEligibilityRequest resource. Tabula Medica standardizes this across all connected providers so your Prior Authorization data is always comparable.
Related Terms
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