What does the term "Authorization" refer to in the context of Epic referrals?

In the context of Epic referrals, "Authorization" specifically refers to the approval required from insurance companies before specific medical services can be provided. This process is essential because many health insurance plans mandate that healthcare providers obtain prior authorization to ensure that the proposed treatment or procedure is covered under the patient's benefit plan. This system aims to manage healthcare costs and ensure that patients receive appropriate care.

Obtaining authorization typically involves verifying medical necessity and ensuring that the service aligns with the insurer's guidelines. This can help prevent unexpected costs for both the patient and the provider. Therefore, understanding the role of authorization in the referral process is crucial for efficient healthcare delivery and compliance with insurance requirements.