Medwave
  • Facebook
  • Instagram
  • Linkedin
  • Twitter
  • YouTube
  • RSS
Call, Text: (412) 219-4789
  • Medical Credentialing
  • Payer Contracting
  • Billing
  • Rate Negotiations
  • Specialties
    • Behavioral Health
    • Primary Care
    • DME
    • Urgent Care
    • Home Health
    • 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
  • Blog
  • FAQ
  • Contact
  • Home
  • Utilization Management

Utilization Management

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 […]

Read More

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

Recent Posts

  • 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

    The Most Common Reasons for Credentialing Denials

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

    How 2026 E/M and Telehealth Rules are Changing

  • 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

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

  • 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

    The Most Common Reasons for Credentialing Denials

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

    How 2026 E/M and Telehealth Rules are Changing

  • 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

  • Male Filipino Medical Doctor Smiling

    The Essential Physician Credentialing Checklist

  • White male medical doctor signing credentialing document

    Can Providers Practice w/ Pending Credentialing Applications?

  • Medical Credentialing Expert Female Mulatto

    Turn Your Payer Contracts Into Higher Reimbursements

Quick Links

  • About Medwave
  • Who We Serve
  • Book a Consultation
  • Google Reviews
  • Testimonials
  • CAQH ProView Form
  • On-Boarding Documentation Checklist
  • Billing / Credentialing Specialties
  • Regions Served
  • New Practice
  • Medical Credentialing
  • Recredentialing
  • Payer Contracting
  • Medical Billing
  • Rate Negotiations
  • Denial Management
  • HL7 Integration
  • Robotic Process Automation (RPA)
  • A/R Recovery
  • Telehealth Billing
  • Revenue Cycle Consulting
  • CPT Code Category Index
  • FAQ
  • Pricing
  • Blog
  • Videos
  • HIPAA Compliance
  • Contact

Quick Connect

  • (412) 219-4789
  • Fax: (866) 422-9277
  • Contact Us
    • Linkedin
    • YouTube
    • Facebook
    • Twitter
    • Pinterest
    • Instagram

Medwave @ Goodfirms

Medwave | Alignable

Medwave @ Inc. 5000

© 2025, Medwave Medical Billing, LLC. | Cranberry Township, PA, 16066 | Phone: (412) 219-4789 | Sitemap | Privacy Policy