Which set of beneficiary information is typically required for a PA?

• A. Name, insurance ID, DOB, address, phone
• B. Name, insurance ID, DOB, address, phone, height, weight, allergies, and patient representative
• C. Only name and date of birth
• D. Height, weight, allergies, patient representative

Answer: (B)

For a prior authorization, the payer needs to confirm who the patient is, how to reach them, and key safety and dosing information. This set provides essential identity details (name, insurance ID, date of birth) plus contact information (address, phone) to locate and communicate with the patient. It also includes height and weight for dosing and safety review, allergies to flag potential contraindications, and a patient representative to handle communications or decisions if the patient can’t. Together, these elements support accurate verification, appropriate medical necessity review, and safe, effective management of the authorization.

The other options miss important pieces: some lack a primary identifier or contact details, while others omit critical safety or authorization-support information like allergies or a designated representative.