Read our latest medical billing and RCM related blogs

Prior Authorization: A Key Step in Streamlining Medical Billing and Patient Care

Prior Authorization in Medical Billing Prior Authorization in Medical Billing has become essential in managing patient care and billing in the fast-evolving healthcare sector. As a fundamental process in medical billing, prior approval serves as a checkpoint that ensures the patient’s insurance covers a procedure, service, or medication before it’s administered. This step is crucial […]

Pre-Authorization in Medical Billing: Streamlining RCM Processes

In the complex landscape of medical billing, pre-authorization plays a crucial role in ensuring effective communication between healthcare providers, insurance companies, and patients. Pre-authorization serves as a mechanism to validate and approve medical procedures, treatments, and services before they are performed or availed. This article explores the concept of pre-authorization in medical billing, its types, […]

Revised Billing Updates for Prior Authorization

Revised Role of Prior Authorization So far insurance carriers have been using prior authorization as a tool to control spending and promote cost-effective care. But in changing billing scenarios role of prior authorizations has changed drastically. There is little information about how often prior authorization is used and for what treatments, how often authorization is […]

Coping up with Changed Requirements of Prior Authorization

Providers continue to wonder how we can live in a world where so many RCM processes are handled quickly with technology, yet decisions that affect patient health are slowed by faxes and bureaucracy, even when there is only one clear treatment option. Yes, you are right, we are talking about Prior Authorization (PA) or Pre-Auth. […]

CMS Proposed a Rule for Improving Prior Authorizations

CMS recently proposed a rule to improve prior authorization processes by reducing the burden on providers and patients. This proposed rule would place new requirements on Medicaid and CHIP managed care plans, state Medicaid and CHIP fee-for-service programs, and Qualified Health Plans (QHP) issuers on the Federally-facilitated Exchanges (FFEs) to improve the electronic exchange of […]