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

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 […]
Cybersecurity, FHIR, Price Transparency, Revenue Cycle, Telehealth BillingWhat is 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 […]
Diagnostic Imaging, Durable Medical Equipment, Pharmaceutical Treatments, Prior Authorization Process, Provider Workflow, Specialist Referrals, Value Based CareWhy Do Health Insurers 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. “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 […]
Prior Authorization Process, Revenue Cycle Management
