Insurance Pre-Authorization

Pre-authorization refers to the process where an insurer approves medical services based on medical necessity prior to services being provided. Determining a pre-authorization requirement is the responsibility of the ordering physician or patient. If the procedure requires pre-authorization, the Office of Inspector General (OIG) acknowledges the ordering physician has the responsibility of acquiring approval for the service.

Each payer may have its own requirements for which party has the responsibility to initiate a pre-authorization – the referring or primary care physician. Many payers do not allow the servicing facility to obtain a pre-authorization. The provider who orders any testing has access to the patient’s medical history and supporting documentation proving medical necessity. This information is often required to obtain a pre-authorization. Campbell County Health believes that obtaining a pre-authorization is the responsibility of the ordering provider, as part of providing care to the patient.

To assist in this process, please refer to the list of common insurance companies in the servicing area below. For more information, please call 307-688-1142.

Disclaimer: This may not be a complete list of all payer authorization requirements. All information is subject to change. An updated list is posted monthly. To obtain access to a payer website, please contact your system administrator for enrollment. For more information, please call 307-688-1142.