Prior authorisation checklist
ProblemPrior authorisation requests are rejected for missing information and have to be redone.
Criteria for a knee replacement pre-authorisation (pasted) + what's in the file
Imaging within 6 months — have (X-ray report)
Failed conservative therapy ≥ 3 months — unclear, physiotherapy dates missing
Request: clinician to confirm therapy start and end dates.
Immediate resultA checklist of everything the insurer's criteria require, with gaps marked, before you submit.


