What is required for claim information submission to determine coverage before treatment?

The correct answer is the precertification provision. In the context of health insurance, a precertification provision is designed to establish whether a proposed treatment or procedure is covered under a policy before it is administered. This process typically involves the healthcare provider submitting information about the patient's condition and the intended treatment to the insurance company, which then assesses the information to confirm if the treatment aligns with the coverage guidelines set forth in the policy.

This provision is crucial as it helps avoid unexpected costs for the insured and ensures that treatments meet necessary medical necessity standards and insurance specifications before they are enacted. By obtaining precertification, patients and providers gain clarity regarding coverage and any potential out-of-pocket expenses that might arise from non-covered services. This proactive step protects both the insurer and the insured by facilitating proper management of health care services.