I was told I needed prior authorization to obtain a service. Whats the difference between prior authorization and a referral?
Prior authorization is the process of obtaining coverage approval from BlueCross BlueShield for a service or medication. Without prior authorization, the service or medication is not covered under your health-plan benefits. Your healthcare provider is responsible for obtaining the prior authorization when required. A referral is the recommendation by a healthcare provider or a health plan for a member to receive care from a different provider or facility.
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