Obtaining prior authorization (PA) is a complex, time-consuming, and often frustrating process that inadvertently delays access to timely patient care. Pre-authorization requirements are stringent, and there is always the risk that the request to the insurer to cover...
Insurance Verification and Authorizations
What Are the Steps Involved in the Pharmacy Prior Authorization Process?
Healthcare providers and patients often report difficulties with health insurers regarding prior authorizations, with many consumers saying their care was either denied or delayed last year, due to...
What Is the Difference between Insurance Verification and Insurance Authorization?
Suppose that you managed to provide exemplary patient care at your medical practice and your patients leave satisfied with the treatment received, leading to positive feedback and improved health...
Five Compelling Reasons to Outsource Dental Insurance Verification
In dental practices, insurance verification sets the stage for efficient revenue cycle management. According to a Dentistry IQ article, dental insurance checks make up approximately 50% of practice...
How to Code and Bill for Mental Health Services
The National Institutes of Health (NIH) concluded that over 20% of Americans (57.8 million) live with some form of mental illness. Treatments include various forms of psychotherapy, medications,...
Radiology Prior Authorization Challenges: Strategies for Optimizing Workflow and Reimbursement
Failure to obtain proper prior authorization is one of the key reasons for claim denials in many medical specialties, and radiology is no exception. Radiology prior authorization is meant to ensure...
Effective Strategies to Obtain Prior Authorizations
Most insurance companies have different regulations, making properly handling prior authorizations challenging. Adding to the problem, payers may add new services to their prior auth list every...
Why Outsource Insurance Eligibility Verification, a Key Step in Revenue Cycle Management?
Is insurance eligibility verification that important for your practice? Yes, it is. Most practices realize that a large proportion of their administrative costs are related to not performing proper...
Verifying Insurance Coverage for CPAP Therapy
Continuous positive airway pressure (CPAP) is the gold standard therapy for the management of obstructive sleep apnea (OSA). Most insurance companies, including Medicare, cover at least part of the...
How Medical Billing Supports the Healthcare Accounting Process
It goes without saying - the financial health of your medical practice is essential. Rising costs, evolving healthcare models, and increased competition have all made this more difficult than years...
Why Outsourcing Preauths and Insurance Verification Is a Game Changer
Medical practices face several challenges that can hinder efficiency and impact revenue cycles. One aspect that the front office often has problems handling is checking patients’ insurance coverage....