As such, in most pediatric cancer centers such as ours, insurance pre-authorization is sought for nearly all new cancer diagnoses prior to obtaining a PET/CT, whether for initial staging or for interim response assessment. CMS approved indications, for which specific reimbursement codes exist, ...
This is called “prior authorization,” and it’s a method used by all kinds of health insurers to reduce wasteful spending on certain services. All states offer dental benefits to children under Medicaid, and most states do for adults, too. According to...
Prior authorization requirements: You may have to get approval from your Medicare Advantage plan to have certain tests or procedures, which can delay care. Plan restrictions: You may have to get a referral from your primary care physician each tim...