What is the correct term for the formal process by which a prescriber requests approval from the insurance plan to cover a service or product?

The correct term for the formal process by which a prescriber requests approval from the insurance plan to cover a service or product is "Prior Authorization." This process is crucial in the healthcare and insurance industries because it ensures that certain medications, procedures, or services are covered by the insurance provider before they are administered or dispensed.

Prior authorization typically involves the healthcare provider submitting specific information about the patient's condition and the requested treatment to the insurance company. It is designed to manage costs and ensure that the treatments being requested are medically necessary and appropriate based on established guidelines.

While "Insurance Verification" refers to checking an individual's insurance benefits and coverage, and "Pre-Approval" may often be used interchangeably with "Prior Authorization," it is not the standard term used in the industry. "Claim Submission" refers to the process of submitting a request for payment from an insurance company after services have been rendered, not before. Therefore, prior authorization is the most accurate term representing the process described in the question.