What does Prior Authorization (PA) ensure regarding medical services?

Prior Authorization (PA) serves to ensure that a review of the medical necessity is conducted before certain medical services or treatments are provided. This process requires healthcare providers to obtain approval from an insurance company or payer before delivering specific services, thereby confirming that the proposed treatment is necessary and appropriate for the patient's condition.

This mechanism is crucial because it aims to prevent unnecessary procedures and costs, ensuring that patients receive beneficial care aligned with established medical guidelines. By requiring this review, insurers can manage their resources better and ensure that prescribed services meet the clinical criteria for necessity.

The other options misrepresent the purpose of prior authorization. There is no guarantee that services will be provided at no cost, nor do all services receive automatic approval through this process. Additionally, patients are generally limited in their choice of providers based on their insurance plan agreements.