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  • Posts tagged "Utilization Management"

Posts tagged "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 […]

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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

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Practices Served

  • Behavioral Health
  • Primary Care
  • DME
  • Urgent Care
  • 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
  • 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

  • FHIR Data Exchange Interoperability

    FHIR® Interoperability: The Hidden RCM Benefit of Real-Time Data Exchange

  • Anthem BCBS Credentialing, Recredentialing, and Contracting

    A Guide to Provider Credentialing with Anthem

  • Colonoscopy CPT Codes with Asian Doctor

    Which CPT Codes are Used in Colonoscopy Billing?

  • White Male Doctor Challenged by RCM

    Rate Negotiations: Get Paid What You Deserve

  • Asthma Treatment CPT Codes

    Which CPT Codes are Used in Asthma Treatment Billing?

  • Male Asian Indian-American Medical Doctor in Need of Credentialing

    The Difference Between Provider and Group Credentialing?

  • White Male Doctor, High Certification

    Which Medical Certification Pays the Most?

  • White Male Telehealth Doctor on Screen

    Do I Need Separate Credentialing for Telehealth?

  • Vasectomy Patient w/ Male Surgeon

    Which CPT Codes are Used in Vasectomy Billing?

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