Pre-hospitalization authorization is an example of which insurance concept?

Pre-hospitalization authorization is indeed an example of managed care. This concept revolves around a healthcare delivery system that aims to manage costs and improve patient outcomes through coordinated care. Managed care often requires patients to obtain authorization before receiving certain medical services, including hospitalizations. This process helps control unnecessary admissions and promotes the use of appropriate and cost-effective care.

In a managed care environment, healthcare providers work within a network to offer services to insured patients. Emphasizing preventive care and early intervention, managed care can lead to more efficient use of healthcare resources. By requiring pre-hospitalization authorization, managed care organizations aim to prevent unnecessary procedures and ensure that patients receive care that is deemed medically necessary.

In contrast, traditional insurance tends to offer less restriction on providers and services, often leading to higher costs for insurers and patients. Cost-sharing involves the distribution of costs between the insurer and the insured, primarily through deductibles, copayments, and coinsurance. Underwriting refers to the process of evaluating the risk of insuring a potential applicant, determining premium rates based on that risk. These concepts underpin the health insurance industry but do not specifically relate to the processes of pre-hospitalization authorization.