Another important aspect of medical billing is prior authorization, commonly referred to as precertification or prior permission, regarding certain medical procedures, medications, etc.
On behalf of the medical staff, we have a separate team of experts who handle the prior authorization procedure with the insurance company.
We make sure to contact insurers in advance, communicate with them regarding certain situations and procedures, and obtain a certification number to be reimbursed properly, depending on the patient's medical necessity and benefit plan. In addition to getting prior approval for our providers, they decide whether prior authorization is necessary for the services being delivered.
Given the current circumstances, prior authorization is routinely used, and the current procedures are excessively onerous. Prior authorization is a problem that needs to be solved through a variety of strategies due to the impact it has on doctors and patients.
