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Prior Authorization

Which CPT Codes are Used in Dermatology Billing?

April 20, 2026 / Alex J. Lau / Billing, CPT Codes, Dermatology Billing, Dermatology CPT Codes, Prior Authorization
Dermatology CPT Codes -- Coder Sitting at Her Desk

Dermatology billing uses a distinct set of CPT codes grouped by procedure type. Those are evaluation and management visits, biopsies, shave removals, excisions, destruction of lesions, Mohs surgery, and phototherapy. The correct code depends not just on what procedure was performed, but on the size, location, and complexity of the lesion, and on whether the […]

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Articles, CPT Codes, Dermatology Billing, Dermatology Claims, Dermatology CPT Codes, Prior Authorization

Medical Billing Trends in 2026: AI, Prior Authorization Reform, Value-Based Payment Shifts

January 1, 2026 / Alex J. Lau / Artificial Intelligence, Medical Billing, Prior Authorization, Value-Based Care
Medical Billing Trends in 2026

Three medical billing trends are having the most immediate operational impact in 2026. AI-powered claim scrubbing and denial prediction becoming standard in billing departments of all sizes, electronic prior authorization reaching meaningful interoperability across major payers, and value-based payment arrangements tying a growing share of reimbursement to quality metrics rather than visit volume. Each trend […]

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Cybersecurity, FHIR, Price Transparency, Revenue Cycle, Telehealth Billing

What is Prior Authorization?

September 19, 2025 / Alex J. Lau / Prior Authorization
Female Doctor Prior Authorization

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 […]

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Diagnostic Imaging, Durable Medical Equipment, Pharmaceutical Treatments, Prior Authorization Process, Provider Workflow, Specialist Referrals, Value Based Care

Why Do Health Insurers Require Prior Authorization?

February 9, 2021 / Alex J. Lau / Prior Authorization
Female Doctor 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. “This procedure will require prior authorization.” 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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Prior Authorization Process, Revenue Cycle Management

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    Credentialing Onboarding for New Providers: A Practice Manager’s Guide

  • Paye Contracting Requirements by State

    Payer Contracting Requirements by State: What Changes; What Stays the Same

  • AI Scribes Changing Medical Coding and Billing

    AI Scribes are Changing Medical Coding, Reimbursement

  • Net Collection Rate, analyzed by analyst

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  • Modifier 96 versus Modifier 97

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