Most insurance plans do not require pre-authorization for a specialty clinic consult. If the specialist orders additional tests, therapies or procedures, our insurance authorization team will request authorization from your insurance plan.
Kaiser Health Foundation Plan of Washington (formerly Group Health Cooperative), NPN, HMSO and TriCare insurance plans always require a pre-authorization before scheduling care at Seattle Children’s. If your child is covered by Kaiser Health Foundation Plan of Washington (formerly Group Health Cooperative), NPN, HMSO or TriCare, make sure you have your authorization number before you schedule an appointment.
If your insurance denies our authorization request, meaning they will not pay for services, we will contact you. Because of the high volume of requests we do each day, we will only notify you if our request is denied.
Pre-authorization does not guarantee your insurance will cover care. Some services do not require pre-authorization, but also are not covered. Because employer groups can customize plans for their employees, there is a wide range of plans and coverage. Contact your insurance to learn what your plan covers.