Title: Competency Assessment: (CU2 M3) Obtain Prior Authorization
Course: SkillsCom CRS 110 14.0 > Section: Credit Unit 2 Module 3

Instructions:

Preauthorization is a decision by your health insurer or plan that a health care service, treatment plan, prescription drug or durable medical equipment is medically necessary.

The following case study is for patient John Q. Smith. He was injured while competing in a rodeo as a bull rider. You as a coding and reimbursement specialist need to get preauthorization for the pain medication that he will need following surgery.

Assignment:

1. Review the following documents:

- Patient information sheet for John Q Smith (PDF Download)
- Physician chart notes for John Q Smith (Google Doc)

2. Based on the information provided in the documentation, complete the preauthorization documentation linked below, which is necessary to submit to the insurance company:

Preauthorization Form (PDF Download)