A technique for minimizing costs, wherein benefits are only paid if the medical care has been pre-approved.
Tag: RAW
prior authorization (PA)
See: prior approval (PA).
Prior authorization number
Group of figures assigned by a managed care plan or insurance program to a specific case after prior approval or precertification for treatment is completed.
Prior coverage
Insurance of an individual before the effective date of another policy and the subscriber has a different identification number.
Prior service
Insurance coverage of an individual who was covered under a previous employer and is now to be covered with the same insurance company under a new employer.
Prior year development
Used to determine the adequacy of reserves across the Lloyd’s market and the benefit of reserve margin to be considered within the combined ratio. It also serves as a comparator of Lloyd’s market underwriting profitability to its peers.
Prior years
Earlier years. This term usually refers to earlier years of account which have been closed into another year of account by reinsurance to close.
Prior-stay dates
The “from” and “through” dates of a patient’s stay in a hospital, skilled nursing facility (SNF), or nursing home that ended within 60 days of the current hospital or SNF admission.
Priority
The term used in some reinsurance markets outside the U.S. to mean the retention of the primary company in a reinsurance agreement.
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Legal preference.
Priority (Reinsurance)
Another term for retention.