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It is crucial for a fee for service providers to understand all necessary payer requirements to get properly paid for the services they provide, and to avoid administrative mistakes that cause thousands of dollars to the practice. The goal of this webinar is to go over one of the most important steps in preparation for services called Prior authorization. We will review what this process means, how to initiate it, what paperwork is needed, what forms to look for, how to get information on prior authorization requirements, and how to handle authorizations when providers are in network and out of network.

Learning Objectives

• To learn the meaning behind prior authorization.
• To understand why prior authorization is needed.
• To go over the steps to figure out if prior authorization is needed.
• To go over the prior authorization requirements for in-network providers.
• To go over the prior authorization requirements for out-of-network providers.
• To go over examples of different payer requirements for prior authorization.
• To go over where to obtain information about prior authorization requirements.
• To discuss ways how to implement a good process for prior authorization verification.

Areas Covered in the Session

• What is the process called Prior Authorization?
• Why prior authorization is needed?
• Steps on how to figure out if prior authorization is needed.
• Prior authorization requirements for in-network providers.
• Prior authorization requirements for out-of-network providers.
• Review examples of different payer requirements for prior authorization.
• Discuss ways how to implement a good process for prior authorization verification.
• Live Q&A

Suggested Attendees

• Medical providers who are involved in the payment process of their practice
• Physicians
• Practice Managers
• Billing Managers
• C-level Executives
• Office Managers
• Medical Billers
• Medical Coders
• Office staff and Billing Managers
• Medical Billing Companies
• Providers’ Office Staff
• Hospital Revenue Cycle Staff

About the Presenter

Kate Gilman has almost two decades of experience in the healthcare industry. She is an expert coder, compliance officer, and trains healthcare providers all over the country. Kate utilizes her expertise to uncover ways to improve billing and coding inefficiencies, training staff, and ensuring compliance while achieving maximum results and revenues for her clients.
Kate’s successes include small and large practices, ranging from primary care to specialists and surgeons. She is known for helping providers feel confident in their coding and peace of mind with their compliance practices. Kate’s acute attention to detail, deep understanding of coding and billing, and proactive approach make her an indispensable asset to all her clients.