Prior Authorization

For some types of care, your primary care provider (PCP) or specialist will need to ask HPSM for permission before you get the care. This is called asking for prior authorization, prior approval or pre-approval. It means that HPSM must make sure that the care is medically necessary or needed.

Care is medically necessary if it is reasonable and necessary to protect your life, keeps you from becoming seriously ill or disabled, or alleviates severe pain.