US Medical Term · insurance
Prior Authorization Denial
Denegación de autorización previa
In 9 languages
| Language | Term |
|---|---|
| English | Prior Authorization Denial |
| Spanish (Español) | Denegación de autorización previa |
| Chinese (中文) | 預先授權拒絕 |
| Korean (한국어) | 사전 승인 거부 |
| Vietnamese (Tiếng Việt) | Từ chối phê duyệt trước |
| Filipino (Tagalog) | Pagtanggi sa prior authorization |
| Portuguese (Português) | Negação de autorização prévia |
| Thai (ภาษาไทย) | การปฏิเสธการอนุมัติล่วงหน้า |
| Japanese (日本語) | 事前承認拒否 |
What it means
A prior authorization denial occurs when your insurance company refuses to approve coverage for a requested service, treatment, or medication before it is provided. Common reasons include the insurer determining the service is not medically necessary, the treatment does not meet clinical criteria, or step therapy requirements were not followed. A denial letter must explain the reason and inform you of your right to appeal. You typically have the right to an internal appeal and then an external independent review. Urgent denials must be resolved within 72 hours; non-urgent cases within 30 days. Your provider can often supply additional information to overturn the denial.
How to say it
Sentences a patient might use with a doctor, nurse, pharmacist, or insurer:
I received a prior authorization denial — what are my options to appeal?
Recibí una denegación de autorización previa — ¿cuáles son mis opciones para apelar?
My doctor wants to submit additional clinical information to overturn the denial.
Mi médico quiere enviar información clínica adicional para revertir la denegación.
What specific clinical criteria did my request fail to meet?
¿Qué criterios clínicos específicos no cumplió mi solicitud?
Where you'll see it
Related terms
Sources
Last reviewed: September 2026