Mastering Prior Authorization in Healthcare: An Overview and Step-by-Step Process
Prior authorization is the most important process in healthcare RCM. Due to errors in prior authorization, claims over $21 million were denied, while that of $291k was written off. It is important to get prior permission from payers to collect payment for the services offered as a healthcare treatment to the patients. Insurance payers might not approve some tests or treatments; practices must wait until they get permission or inform the patients about the costs. Prior authorization (PA) is a long process that requires the collaboration and involvement of patients, payers, and healthcare providers. This blog will help you understand the prior authorization process and the steps involved in it. Explain prior authorization It is a process followed by insurance providers to check if the suggested medical procedures, tests, or treatments are necessary for that medical condition. Insurance payers reject reimbursements if a healthcare provider fails to take prior authorizatio...