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Prior Authorization

Where Should Providers Focus their Billing Resources?

October 7, 2024 / admin / Articles, Medical Billing, Medical Billing AI, Patient Experience, Patient Registration, Patient Responsibility, Practice Management, Prior Authorization, RCM, Revenue Cycle Automation, Robotic Process Automation, RPA
Medical Billing Resources

Effective medical billing is crucial for the financial health and sustainability of healthcare providers. With limited resources and increasing administrative burden, providers must strategically allocate their billing resources to maximize revenue while maintaining compliance and patient satisfaction. This analysis explores key areas where healthcare providers should focus their medical billing efforts to optimize outcomes and […]

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Medical Billing, Medical Billing AI, Medical Billing Tips, Medical Billing Trends, Patient Experience, Patient registration, Patient Responsibility, Practice Management, Prior Authorization, RCM, Revenue Cycle Automation, Revenue Cycle Management, Robotic Process Automation, RPA

How to Optimize Billing Reimbursement

August 7, 2024 / admin / Articles, Automation, Charge Capture, Denial Management, Denial Management Process, Patient Collections, Payer Contracting, Payer Contracts, Payer Enrollment, Payor Contract, Prior Authorization, Prior Authorization Process, Prior Authorizations, Proper Coding, RCM, Revenue Cycle, Value-Based Models
Navigating Fee Schedules and Reimbursement Rates

Effective billing practices are crucial for healthcare providers, medical offices, and businesses across various industries to maintain financial stability and ensure proper compensation for services rendered. Optimizing reimbursement in billing involves implementing strategic processes, leveraging technology, and staying compliant with industry regulations. We discuss key strategies and best practices to maximize reimbursement rates and streamline […]

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Automation, Charge Capture, Denial Management, Denial Management Process, Patient Collections, Payer Contracting, Payer Contracts, Payer Enrollment, Payor Contract, Prior Authorization, Prior Authorization Process, Prior Authorizations, Proper Coding, RCM, Revenue Cycle, Value-Based Models

Why Do Health Insurers Require Prior Authorization?

February 9, 2021 / admin / Articles, Healthcare, Medical Billing, Medical Credentialing, Medicare, Prior Authorization, Prior Authorization Process, Revenue, Revenue Cycle, Revenue Cycle Management, Utilization Management
Female Mulatto Doctor Prior Authorization

“This procedure will require prior authorization.” Words that no patient or healthcare provider wants to hear when they are ready to proceed with a doctor-approved procedure for a medical matter. However, it’s one of the utilization management tools that insurance companies have fostered to decide if specific prescribed procedures, services and medications are medically required […]

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Health Insurance, Healthcare, Healthcare Providers, Medical Billing, Medical Credentialing, Medical Practice, Medicare, Prior Authorization, Prior Authorization Process, Revenue, Revenue Cycle, Revenue Cycle Management, Utilization Management

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Practices Served

  • Behavioral Health
  • DME
  • Urgent Care
  • Speech Therapy
  • Geriatric Medicine
  • Skilled Nursing Facilities (SNF)
  • Substance Abuse
  • Genetic Testing
  • Pharmacogenetic (PGx)
  • Toxicology
  • Allergy Testing
  • Oncology
  • Pathology
  • OBGYN
  • Internal Medicine
  • Biologics and Specialty Drugs
  • Telestroke and Teleneurology
  • Digital Therapeutics (DTx)
  • Remote Patient Monitoring
  • Remote Therapeutic Monitoring
  • Home Infusion Therapy
  • Sleep Study Labs
  • Physical Therapy (PT)
  • Occupational Therapy
  • COVID-19 Testing

Practices Served

  • Behavioral Health
  • DME
  • Urgent Care
  • Speech Therapy
  • Geriatric Medicine
  • Skilled Nursing Facilities (SNF)
  • Substance Abuse
  • Genetic Testing
  • Pharmacogenetic (PGx)
  • Toxicology
  • Allergy Testing
  • Oncology
  • Pathology
  • OBGYN
  • Internal Medicine
  • Biologics and Specialty Drugs
  • Telestroke and Teleneurology
  • Digital Therapeutics (DTx)
  • Remote Patient Monitoring
  • Remote Therapeutic Monitoring
  • Home Infusion Therapy
  • Sleep Study Labs
  • Physical Therapy (PT)
  • Occupational Therapy
  • COVID-19 Testing

Recent Posts

  • White Male Doctor w/ Black Female Administrator

    10 Credentialing KPIs Every Healthcare Provider Should Know

  • Artificial Intelligence Robot Thinking

    How is AI Being Used in Healthcare?

  • Payer Contract Negotiations, with White Male Medical Doctor

    10 Payer Contracting Use Cases

  • White Male Medical Doctor Needing Credentialing

    Struggling with Credentialing? Medwave Can Help!

  • Agreement to Negotiate Contracts in Healthcare

    How to Restructure Payer Contracts

  • White Female Medical Doctor Smiling

    Credentialing for New Graduates: From Residency to Practice

  • Payer Contract Management in Healthcare

    Payer Contract Management Strategies for Healthcare Providers

  • Medical Credentialing Workflow

    Credentialing Workflow Optimization

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