Which of the following is required information in a prior authorization claim?

Prepare for the Prior Authorization Certified Specialist Exam. Study with multiple choice questions, each with hints and explanations. Ace your exam with confidence!

In a prior authorization claim, the required information typically includes specific details about the patient that are necessary for the insurance provider to evaluate the request for coverage. Among the options provided, height (listed as either centimeters or inches) is relevant as it can be pertinent for determining the medical appropriateness of certain treatments or medications, especially those related to conditions that are weight or height dependent.

The inclusion of height in the prior authorization process ensures that the treatment aligns with clinical guidelines and standards. For instance, medication dosages for certain drugs might need to be calculated based on a patient's body mass index (BMI), which requires accurate height measurements.

In contrast, requesting a patient's social security number is generally not a standard requirement for prior authorization, as it is sensitive personal information not typically needed for this process. The insurance premium amount is more relevant to billing and payment rather than immediate medical necessity determinations. Previous hospital visits, while sometimes useful for context, are not universally required for every prior authorization claim. The focus is on information directly related to the current treatment being requested, which is where height becomes significant.

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