Prior Authorization

Prior authorization denials happen when a service needed pre-approval but it wasn’t obtained before the service was performed. In some cases, retroactive authorization is possible.

• Medicare Denied Claim: No Prior Authorization
  Medicare denied your claim because prior authorization was not obtained before the service. Learn why this happens, your appeal options, and what steps to take next.
• Medicare Denied Claim: Prior Authorization Expired
  Medicare denied your claim because the prior authorization expired or did not match the service provided. Learn what this means, your options, and what to do next.
• Medicare Denied Claim: Referral Missing or Invalid
  Medicare denied your claim because a required referral was missing or invalid. Learn why this happens, how your provider can fix it, and whether you need to appeal.
• Medicare Denied Prior Authorization Request
  Your Medicare plan denied your prior authorization request for a service. Learn why prior auth requests get denied, how this differs from a claim denial, and how to appeal.