Which of the following should be included in a prior authorization claim? (Select all that apply)

Including previous drug trials in a prior authorization claim is crucial because it provides the insurance company with essential context about the patient's treatment history. This information helps assess the medical necessity for the requested medication or treatment. Prior authorization is often sought when a prescribed medication is not typically covered under a patient's plan without further justification, and detailing previous trials can demonstrate that the patient has not responded to other treatments or has experienced adverse effects. This justifies the need for the requested therapy, making it a key component.

In contrast, information such as a patient's height is generally not required for prior authorization claims and does not directly contribute to the justification for coverage of the medication. Outdated medication history may not offer relevant insights into the patient's current treatment needs, as it does not reflect the most recent treatment approaches or responses. While a diagnosis, represented by an ICD-10 code, is important in many contexts, the focus on previous drug trials specifically underscores the emphasis on the patient's prior experiences with treatments when obtaining approval.