[{"@context":"https:\/\/schema.org\/","@type":"BlogPosting","@id":"https:\/\/reflexknees.com\/blogs\/preauthorization-understanding-health-insurance-part-2\/#BlogPosting","mainEntityOfPage":"https:\/\/reflexknees.com\/blogs\/preauthorization-understanding-health-insurance-part-2\/","headline":"Preauthorization \u2013 Understanding Health Insurance, Part 2","name":"Preauthorization \u2013 Understanding Health Insurance, Part 2","description":"  Due to changing health care laws over the past couple years, the Reflex team has seen many health\u00a0insurance companies change their requirements and coverage for\u00a0Joint Fluid Therapy\u00a0(HA Injections). Many insurance companies now require pre-approval or preauthorization\u00a0before\u00a0any practice can treat you.   Pre-authorization is an extra step that many insurance companies require for their plan […]","datePublished":"2015-08-02","dateModified":"2024-01-09","author":{"@type":"Person","@id":"https:\/\/reflexknees.com\/author\/developer\/#Person","name":"Nick Petersen","url":"https:\/\/reflexknees.com\/author\/developer\/","identifier":2,"image":{"@type":"ImageObject","@id":"https:\/\/secure.gravatar.com\/avatar\/8ea7fc410413ee0b715aee4c6b2d912c09623af5f85eaca6f6d7e0a2c223e1df?s=96&d=mm&r=g","url":"https:\/\/secure.gravatar.com\/avatar\/8ea7fc410413ee0b715aee4c6b2d912c09623af5f85eaca6f6d7e0a2c223e1df?s=96&d=mm&r=g","height":96,"width":96}},"publisher":{"@type":"Organization","name":"Reflex Knee Specialists","logo":{"@type":"ImageObject","@id":"http:\/\/b1ec2b6df7.nxcli.io\/wp-content\/uploads\/2023\/03\/logo.png","url":"http:\/\/b1ec2b6df7.nxcli.io\/wp-content\/uploads\/2023\/03\/logo.png","width":169,"height":104}},"image":{"@type":"ImageObject","@id":"https:\/\/reflexknees.com\/wp-content\/uploads\/2023\/06\/2625808.webp","url":"https:\/\/reflexknees.com\/wp-content\/uploads\/2023\/06\/2625808.webp","height":1044,"width":1536},"url":"https:\/\/reflexknees.com\/blogs\/preauthorization-understanding-health-insurance-part-2\/","about":["Blogs"],"wordCount":532,"articleBody":" Due to changing health care laws over the past couple years, the Reflex team has seen many health\u00a0insurance companies change their requirements and coverage for\u00a0Joint Fluid Therapy\u00a0(HA Injections). Many insurance companies now require pre-approval or preauthorization\u00a0before\u00a0any practice can treat you. Pre-authorization is an extra step that many insurance companies require for their plan members before they agree to\u00a0pay for\u00a0treatments at your regular\u00a0co-insurance rate. Reasoning behind\u00a0pre-authorization may vary but, generally, insurance companies require this step for quality assurance and cost control. How do I get pre-authorized for joint fluid therapy? Your first step is to schedule an evaluation. We will measure changes in your mobility through a few basic functionality tests, perform a manual exam to note any physiological changes, and discuss the symptoms and pain you\u2019re currently experiencing. They may also use X-ray or Ultrasound to for additional diagnostics.\u00a0During\u00a0this visit,\u00a0your doctor will create chart notes detailing the current state of\u00a0your knee health and why their recommendations for therapy. Our office submits this paperwork from the visit to your insurance provider with the request for treatment based on the physician\u2019s findings. Your insurance company will review this information to determine if\u00a0they think it meets their\u00a0previously established\u00a0guidelines for coverage of joint fluid therapy. They will notify both you and Reflex when the treatment request is approved or denied. If your treatment is approved, Reflex will contact you to schedule your next appointment. If the request is denied,\u00a0we will automatically submit an appeal to the insurance company, asking them to reconsider approval for treatment. Sometimes this requires us to submit additional information and records, or have one of our physicians speak with an insurance appointed physician reviewer. Why do insurance companies deny treatment? An insurance company may deny your claim for one of three reasons:The service isn\u2019t covered by your policy.The insurance company does not consider the requested service as medically appropriate\/necessary.\u00a0There was not enough information provided to approve the treatment.This process can be frustrating for both patients and doctors offices. It can require an extra visit to the office by you, and additional paperwork and processing by the insurance department here at Reflex. We do everything we can to get your insurance policy to cover your treatments based on your plan and work hard\u00a0to get you treatment when you need it. How do I know if my insurance requires pre-authorization for Reflex treatments? If you want to find out if your insurance company requires pre-authorization for our treatments, we encourage you to contact your provider directly. We offer a step-by-step guide on our website that explains\u00a0how to check your coverage, with specific questions you can ask your insurance representative. Although the process can be complicated, Reflex will work with you and your insurance company to provide you with the best treatments possible. Please call us if you have any questions. At Reflex, we pride ourselves on being Portland\u2019s knee pain experts. If you\u2019re looking for relief, give us a call today at (503) 719-6783."},{"@context":"https:\/\/schema.org\/","@type":"BreadcrumbList","itemListElement":[{"@type":"ListItem","position":1,"name":"Blogs","item":"https:\/\/reflexknees.com\/blogs\/#breadcrumbitem"},{"@type":"ListItem","position":2,"name":"Preauthorization \u2013 Understanding Health Insurance, Part 2","item":"https:\/\/reflexknees.com\/blogs\/preauthorization-understanding-health-insurance-part-2\/#breadcrumbitem"}]}]