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Prior Authorizations

What is Prior Authorization?

September 19, 2025 / admin / Articles, Diagnostic Imaging, Pre-Approval, Pre-Authorization, Pre-Authorization Process, Prior Authorization, Prior Authorization Process, Prior Authorizations, Services Requiring Prior Authorization
Female Mulatto 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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Articles, Diagnostic Imaging, Pre-Approval, Pre-Authorization, Pre-Authorization Process, Prior Authorization, Prior Authorization Process, Prior Authorizations, Services Requiring Prior Authorization

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

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Practices Served

  • Behavioral Health
  • Primary Care
  • DME
  • Urgent Care
  • Cardiology Billing, Credentialing
  • Speech Therapy
  • Geriatric Medicine
  • Skilled Nursing Facilities (SNF)
  • Substance Abuse
  • Genetic Testing
  • Pharmacogenetic (PGx)
  • Toxicology
  • Allergy Testing
  • Oncology
  • Pathology
  • OBGYN
  • Internal Medicine
  • Podiatry
  • 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
  • Primary Care
  • DME
  • Urgent Care
  • Cardiology Billing, Credentialing
  • Speech Therapy
  • Geriatric Medicine
  • Skilled Nursing Facilities (SNF)
  • Substance Abuse
  • Genetic Testing
  • Pharmacogenetic (PGx)
  • Toxicology
  • Allergy Testing
  • Oncology
  • Pathology
  • OBGYN
  • Internal Medicine
  • Podiatry
  • 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 Medical Doctor in need of Credentialing, at Hospital

    Credentialing: Provider Pain Points

  • White Female Medical Office Manager

    Acceleration of Revenue Cycle Metrics for Physician Groups

  • White Male Congressman slamming gavel

    The Recurring Telehealth Crisis: When Budget Debates Threaten Patient Care

  • Medical Credentialing Specialist, Hispanic Female

    Credentialing Case Studies: Challenging Provider Histories

  • Home Health Worker, White Female Treating a Male Patient

    Mastering Payer Contracts in Home Health

  • White Female Medical Credentialing Expertise

    Who Does Credentialing in a Healthcare Organization?

  • Primary Care Medical Billing, Credentialing

    Which CPT Codes are Used in Primary Care Billing

  • A Group of Contracted Doctors Standing in Times Square

    Provider Challenges in Payer Contracting

  • White Female Master Medical Credentialing Expert

    Complete Credentialing and Enrollment Process for Providers

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