Prior authorization is a fundamental healthcare process that requires healthcare providers to obtain approval from insurance companies or healthcare organizations before delivering specific medical services, treatments, or procedures to patients. This approval mechanism serves as a crucial gatekeeping function that ensures medical services are medically necessary, cost-effective, and appropriate for the patient’s condition before they […]
Articles, Diagnostic Imaging, Pre-Approval, Pre-Authorization, Pre-Authorization Process, Prior Authorization, Prior Authorization Process, Prior Authorizations, Services Requiring Prior Authorization
Let’s be real, billing and claims processing is probably not what got you into the behavioral health field in the first place. You were driven by a passion to help people overcome mental health challenges, develop positive coping strategies, and improve their overall well-being. But as much as we might wish it were different, managing […]
Behavioral Health, Behavioral Health Billing, Billing, Billing Best Practice, Billing Challenges, Billing Codes, Coding, Coding and Billing, Modifier Codes, Modifiers, Pre-Authorization, Preauthorization
As US healthcare costs continue rising steeply – now over $4 trillion representing nearly 20% of GDP – both federal and state policymakers urgently seek ways to contain runaway expenditure growth. This drive manifests through expansion of programs like Medicare Advantage and Medicaid managed care coupled with accelerating passage of game-changing legislation like No Surprises […]
Billing, Billing Best Practice, Billing Disruption, Billing Revenue, Claim Data, Consumer-Centered Billing, Good Faith Estimates, Health Level 7, Healthcare, HL7, Interoperability, Medicaid, Medical Billing Regulations, Medicare, No Surprises Act, Pre-Authorization