Common use of Prior Authorization Requirements Clause in Contracts

Prior Authorization Requirements. Services provided under this Agreement must conform to the requirements for medical necessity, authorization, pre-authorization, or tracking as defined in protocols located in the Provider Requirements. An authorization does not necessarily guarantee the payment for any services rendered to the consumer.

Prior Authorization Requirements. Services provided under this Agreement must conform to the requirements for medical necessity, authorization, pre-authorization, or tracking as defined in protocols located in the Provider RequirementsManual. An authorization letter does not necessarily guarantee the payment for any services rendered to the consumer.