Which statement is true regarding prior authorizations?

The statement regarding prior authorizations that is true is that different departments handle medication and service line prior authorizations. This reflects the operational reality within many healthcare institutions and insurance companies, where specialized teams manage prior authorizations for distinct categories of healthcare services and products.

Medications often require a separate evaluation process due to formularies and specific clinical guidelines, while other services such as surgical procedures, imaging, or therapy may have their own criteria and departments focused on those types of requests. This division allows for a more thorough and specialized review process, ultimately aiming to ensure that all requests align with clinical necessity and payer policies.

The other statements do not hold true universally or reflect the complexity of the prior authorization process. It is not accurate that most payers use a single department for all prior authorizations, as many have multiple departments based on service areas. Not all medications require prior authorization; many are covered without a need for this additional step depending on the payer and the specific medication. Finally, prior authorization is not limited to surgery; it can also be necessary for various other services, procedures, and medications.