Please click on the below link:
willisgroupservices.com/PROD2LZ/lz.aspx?p1=05063702S5697&CC=&p=0
Also called coverage determination. A decision by your health plan about whether a service is medically-necessary and covered by the Policy. Often certain types of care or dollar amounts trigger the need for the insurer to pre-authorise services. Note that proposed fees do not have to be submitted by the provider for a pre-authorisation so the patient is advised to ask about the fees vs. coverage levels too.