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:

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)