Competent revenue cycle management(RCM) is essential for keeping medical practices and hospitals financially healthy. Obtaining prior authorization or approval from health plans to order specific medications, procedures or studies is one of the most challenging...
Health insurance carriers require prior authorization (PA) as a condition of payment for many services. Payers use PA to determine if certain medications, products, treatments or services are medically necessary before they are prescribed/rendered to beneficiaries....
A December 2017 study from the American Medical Association reported that 86 percent of physicians said that prior authorizations have increased during the prior five years, with 51 percent saying that they have increased significantly. The PA process for approval of...
One of the administrative challenges that physicians have to deal with is obtaining prior authorizations for prescriptions and testing. This has led to an increase in the demand for insurance authorization services in recent years. Prior authorization is major problem...
Health insurance companies normally require prior authorization for medications, durable medical equipment (DME) and medical services, and insurance authorization services are available to help handle the administrative burden associated with the process. However, the...