Which of the following are steps involved in the prior authorization process?

The prior authorization process is a structured sequence of activities that ensures a patient's proposed medical service or treatment is covered by their insurance plan, based on established medical necessity criteria. Comparing the patient plan with medical necessity and authorization submission captures two critical components of this process.

Firstly, understanding the patient's insurance plan is crucial. This includes determining what services are covered, any specific requirements, and the criteria that must be met for a service to be authorized. Secondly, aligning these coverage details with the medical necessity of the treatment sought is essential. This involves reviewing clinical guidelines, relevant medical records, and treatment plans to substantiate the need for the requested service. Once this comparison is made, the authorization request can be submitted to the insurer.

The other options do not encompass the full scope of necessary steps in the prior authorization process. Verification of insurance only addresses one part of the overall process and does not include the important steps of assessing medical necessity or submitting documentation. Waiting for patient approval is not a standard step, as the process primarily involves communication between healthcare providers and insurance companies. Lastly, while documentation review is certainly an important aspect, it is more of a subset within the broader action of comparing the patient plan with medical necessity before submitting the authorization request.