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Healthcare and Prior Authorization

The term prior authorisation has a specific meaning within the concept of health care and health insurance, and has a fundamental effect on virtually all of the procedures and clinical assessments that an individual is likely to come up against in the context of their health insurance policy. Health insurance differs from other types of insurance policies in a number of ways, but in the context of the term prior authorisation there is a fundamental difference that has to be appreciated. In most other types of insurance, an event or catastrophe occurs, and as long as such event is covered under the terms of the insurance policy, then the insurance company is liable to pay subject to terms and conditions etc. There is an implicit contract between the individual and insurance company, where the individual pays the company some money, and the company pays the individual money if and when an event that is insured against happens. Health insurance is different. An individual pays the insur