Get Preauthorization Request Form - Injury Management Organization Inc

The prior authorization process begins when a service prescribed by a patient's physician is not covered by their health insurance plan. Communication between the physician's office and the insurance company is necessary to handle the prior authorization.

Founded in 1991, Injury Management Organization, Inc. (IMO) is a managed care company serving public and private employers, nonsubscribers, insurance carriers and third party administrators.

A decision by your health insurer or plan that a health care service, treatment plan, prescription drug or durable medical equipment is medically necessary. Sometimes called prior authorization, prior approval or precertification.

Prior authorization (also called “preauthorization” and “precertification”) refers to a requirement by health plans for patients to obtain approval of a health care service or medication before the care is provided. This allows the plan to evaluate whether care is medically necessary and otherwise covered.

Prior authorization (also called “preauthorization” and “precertification”) refers to a requirement by health plans for patients to obtain approval of a health care service or medication before the care is provided. This allows the plan to evaluate whether care is medically necessary and otherwise covered.

Prior authorization—sometimes called precertification or prior approval—is a health plan cost-control process by which physicians and other health care providers must obtain advance approval from a health plan before a specific service is delivered to the patient to qualify for payment coverage.

Clinical information specific to the treatment requested that the payer can use to establish medical necessity, such as: Service type requiring authorization. This could include categories like ambulatory, acute, home health, dental, outpatient therapy, or durable medical equipment. Service start date. CPT and ICD codes.