Pre-Authorisation

Pre-authorisation is the request a hospital sends a payer before treating an insured patient on credit, setting out the diagnosis, the planned treatment and the estimated cost. The payer responds with an approval, a partial approval or a rejection, and that response determines how much of the eventual bill will be settled by them rather than the patient.

Why it matters in a hospital

The approved amount and the final bill are frequently different, and the gap is the patient's — which makes it a conversation that has to happen before discharge, not at it. An approval for a sum lower than the estimate, or an exclusion nobody noticed, becomes a dispute at the billing counter at precisely the moment a family is least able to absorb it. Keeping the approval letter attached to the encounter, and reconciling against it as charges accrue, is what prevents the surprise.

How Trisvio handles it

Trisvio has no pre-authorisation workflow and no payer integration; approvals are obtained outside it. What it does provide is a running bill for an admitted patient, so the amount accruing can be compared against an approval held on paper before it becomes a discharge-counter argument.