Which describes the status when a claim does not include required pre-authorization for a service?

• A. Pending
• B. Denied
• C. Approved
• D. In Review

Answer: (B)

Missing required prior authorization means the service wasn’t approved before it was performed, so the payer cannot reimburse the claim. When a policy requires preauthorization and it isn’t obtained, the claim is typically denied because the payer has not verified coverage or medical necessity for that service. The other statuses imply some action or approval is still in process (pending awaiting information, in review while under evaluation, or approved), but without the required authorization there isn’t a basis for payment, making denial the correct outcome.