Question 6024 of 287 · Texas Life, Accident and Health Agent Exam

A pre-authorization (prior approval) requirement means that

Exactly one answer is correct.

Athe insurer must approve certain services before they are performed in order for the services to be covered
Bthe insured must file a claim within 24 hours after a service
Cthe insurer will pay for a service first and recover from the insured later, as agreed between the agent and the insurer
Dthe provider must be approved by the state

Show solution

Correct answer to question 6024

A: the insurer must approve certain services before they are performed in order for the services to be covered

Explanation

Failure to obtain pre-authorization may result in reduced or denied benefits. It is a common managed care tool.