Certified Medical Administrative Assistants (CMAA) Practice Exam 2025 - Free CMAA Practice Questions and Study Guide

Question: 1 / 400

What is a "pre-authorization" in insurance?

A confirmation of payment for services rendered

Approval from an insurance company before a procedure or service is provided

A "pre-authorization" is a crucial step in the insurance process whereby an insurance company gives approval before a specific procedure, treatment, or service is carried out. This process ensures that the proposed service is medically necessary and covered under the patient's insurance policy. By obtaining pre-authorization, healthcare providers can confirm that the costs associated with the upcoming procedure or service will be reimbursed by the insurer, which helps prevent unexpected charges for both the patient and the provider.

In contrast, the other options present different aspects of the insurance and healthcare billing process. A confirmation of payment for services rendered refers to the actual financial transaction that occurs after services have been provided, not the prior approval needed before proceeding with treatment. A type of insurance policy simply describes the various plans offered by insurers and does not specifically address pre-authorization. Lastly, a bill for services provided is a document outlining charges after care has been delivered, which wouldn’t involve prior authorization. Thus, the approval before services are rendered, which embodies the essence of pre-authorization, is integral to ensuring patients receive appropriate care covered by their insurance.

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A type of insurance policy

A bill for services provided

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