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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
  • Home Health
  • Urgent Care
  • Cardiology
  • Skilled Nursing Facilities (SNF)
  • Substance Abuse
  • Speech Therapy
  • Genetic Testing
  • Geriatric Medicine
  • 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
  • Home Health
  • Urgent Care
  • Cardiology
  • Skilled Nursing Facilities (SNF)
  • Substance Abuse
  • Speech Therapy
  • Genetic Testing
  • Geriatric Medicine
  • 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

  • Healthcare Executive Discussing Credentialing Bottlenecks

    Credentialing Bottlenecks: How to Fix Slow Onboarding

  • White Male Doctor Talking to a Female Hispanic Woman

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  • White Male Doctor Challenged by RCM

    How to Manage the 5 Biggest Challenges in RCM

  • Medical Credentialing with PacificSource

    A Guide to Provider Credentialing with PacificSource

  • Male Medical Providers in White Jackets in Need of Credentialing

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  • HomeAlternative Payment ModelsHow 2026 E/M and Telehealth Rules are Changing How 2026 E/M and Telehealth Rules are Changing

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  • White Male Medical Doctor Needing Credentialing

    Professional and Peer References in Medical Credentialing

  • How to Fight Back Against Low Out-of-Network Payments

    How to Fight Back Against Low Out-of-Network Payments

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    The Essential Physician Credentialing Checklist

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