administration

Prior Authorization

事前承認 (jizen shōnin)

Prior authorization (PA) is approval from your insurance company required before you receive certain medical services, medications, or procedures. Without it, the insurer may deny the claim or pay a reduced amount. Common services requiring PA include surgery, MRI/CT scans, brand-name drugs, specialist visits under some plans, and durable medical equipment. The requesting provider submits clinical justification; approval decisions are typically required within set timeframes under state law.

Urgent prior auth decisions must often be made within 72 hours under federal rules; standard decisions within a few business days.

In 9 languages

Language	Term
English	Prior Authorization
Japanese (日本語)	事前承認
Chinese (中文)	预授权
Korean (한국어)	사전 승인
Portuguese	Autorização Prévia
Spanish	Autorización Previa
Filipino	Prior Authorization
Thai	การอนุมัติล่วงหน้า
Vietnamese	Ủy quyền trước
Romanization	jizen shōnin

Related terms

• Referral 紹介状
• Drug Formulary 処方薬リスト
• Prior Auth (Authorization) 事前承認（Prior Auth）
• Step Therapy 段階的治療（ステップセラピー）

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