You must get permission from your insurance administration to approve the medical services you’re asking for. Usually, it requires medical records and physician documentation to designate why the procedure is requested. It must be approved BEFORE you receive services. The requirement is usually that the service is “medically necessary,” and the decision is in the hands of the insurance company. You are also known as prior authorization, prior approval. Pre-certification, while similar, is usually used for elective, non-urgent services.