What Is Prior Authorization? Prior authorization, also known as ‘prior auth’ or P.A or pre-certification, is a standard management process in the healthcare industry where a healthcare provider gets approval from the patient’s insurance company before prescribing a...
Running a healthcare practice is just like running any other kind of business. As physicians provide patient-centered care for a wide variety of conditions, they also need to pay attention to their...
Maintaining and navigating health insurance is crucial for patients to pay for their hospital visits, surgery, and other serious issues. Likewise, to improve collections and make the best decisions...
Urgent care centers provide access to healthcare for patients with an urgent medical condition that is not considered life-threatening, but still needs immediate treatment as it has the potential to...
The growth of ambulatory surgery centers (ASCs) is a positive trend. Technological advancements have made it possible for a wider range of procedures to be performed safely and efficiently on an...
There are a wide variety of radiology procedures to help diagnose the cause of symptoms, monitor the body's response to a treatment, and screen for different illnesses, such as cancer and heart...
As physicians focus on addressing their patients' health concerns, they also need to pay attention to the health of their practice's revenue cycle. Insurance eligibility verification is the first...
Prior authorization (PA) — also referred to as preauthorization, preapproval and precertification — is a tool that is health insurance companies use to ensure patients receive treatments and...
Utilization management (UM) reviews are a component of the value-based care approach. They aim to determine if the care provided to patients is appropriate, efficient, and linked to improved patient...
Earning sufficient revenue to cover overhead expenses and provide quality care is a major challenge for healthcare practices and hospitals. In addition to numerous declining reimbursements,...
Medical billing companies play a vital role in helping physicians reduce claim denials and enhance the patient experience through strategies such as insurance verification, preauthorization, and...