How Do I Handle Out-of-Network Billing Situations?

November 11, 2025 / Alex J. Lau /

Out-of-network (OON) billing occurs when you provide services to a patient whose insurance plan you don’t have a contract with. While these situations can be more complex than in-network billing, they can also be more profitable if handled correctly. Key Steps for Out-of-Network Billing: 1. Verify Benefits and Set Expectations Before providing services, verify the […]

What is Prior Authorization and How Does it Affect My Revenue Cycle?

November 11, 2025 / Alex J. Lau /

Prior authorization (PA) is a cost-control process used by insurance companies that requires providers to obtain approval before performing certain services, procedures, or prescribing medications. The payer reviews the medical necessity of the proposed treatment before agreeing to cover it. How Prior Authorization Affects Your Revenue Cycle: Prior authorization significantly impacts your practice’s revenue cycle […]