Approval from an insurance company prior to certain health care services.

• A. Preauthorization
• B. Primary Care Provider
• C. Managed Care
• D. Integrity

Answer: (A)

Approval from an insurance company before delivering certain health care services is called preauthorization (prior authorization). This process involves the provider or patient requesting the insurer’s approval to cover a specific test, procedure, or treatment. The insurer assesses medical necessity, appropriateness, and plan benefits, often requiring clinical information or documentation. If approved, the service is authorized for coverage; if not, the patient may need to pursue a covered alternative or appeal the decision. The other terms don’t fit this scenario: a Primary Care Provider is the doctor who coordinates care, Managed Care is the overall system for organizing and financing care within networks, and Integrity is not related to insurer approval.