Prior authorization — also referred to as preauthorization, preapproval and precertification — is a strategy that health insurance companies use to ensure that patients receive treatments and medications that are medically necessary, appropriate, safe, and...
Utilization management (UM) reviews are a component of the value-based care approach. They aim to determine if the care provided to patients is appropriate, efficient, and linked to improved patient outcomes. The UM processes of insurance companies include prior...
Our medical billing and coding company is glad to announce that our articles “March is National Kidney Month: Know How the Kidneys Support Your Health” by Amber Darst and “Top Strategies to Streamline Prior Authorizations” by Meghann Drella, CPC have been featured in...
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....