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What You Need to Know About Prior Authorization Processes

Presenter Kate Gilman, CPC, CPCO
Broadcast Date 2/5/2025
Time 10:00am PT / 11:00am MT / 12:00pm CT / 1:00pm ET
Presentation Length 60 minutes
Price $65 (Non-members $85)
What You Need to Know About Prior Authorization Processes Webinar

Learn more about this event

Prior authorization is a crucial factor in revenue cycle management. Understanding the processes of prior authorization, communicating to medical providers and staff on medical necessity and timelines are all important. Many practices overlook obtaining benefits prior to visits, causing a lot of delays in payments and lost revenue. Learning about proper verification of benefits, understanding prior authorization and it’s processes will not only reduce denials, but significantly improve cashflow.

In this presentation we will review everything one needs to know about prior authorization processes for in and out of network providers, general requirements and suggested plan on how to structure a workflow related to prior authorizations.

Learning Objectives/Agenda

• Review what prior authorization means in the healthcare world and why understanding prior authorization process is important.
• Review prior authorization requirements for in-network providers.
• Review prior authorization requirements for out-of-network providers.
• Review best practices on prior authorization workflow to prevent decrease in cashflow.

Why is this topic important?

Prior authorization is not a guarantee of payment. However, lack of obtaining prior authorization when it was required will guarantee the denial. Therefore, it is important to understand the process of obtaining prior authorization.

Who would benefit from this topic?

• Authorization Specialists
• Office Mangers, Billing Managers
• Revenue Cycle Staff
• Practice Owners
• Medical Coders
• All Office Staff

What is the presenter's background/expertise on this topic?

Gilman been working in the healthcare industry for over 20 years. She has been specializing in revenue cycle management, uncovering and correcting all billing inefficiencies and errors, while streamlining operations to achieve maximum results. Authorizations processes is one of the contributing factors that cause billing inefficiencies when not done correctly.

Kate Gilman, CPC, CPCO

About The Author

Kate Gilman, CPC, CPCO

Kate has over two decades of revenue cycle management experience in the healthcare industry. She is an expert at uncovering and correcting all billing inefficiencies and errors, while streamlining operations to achieve maximum results. Kate’s successes include small and large practices, ranging from primary care to specialists and surgeons. She is known for keeping accounts receivables as low as possible, while ensuring collections are optimized. Kate’s acute attention to detail, deep understanding of coding and billing, and proactive approach, make her an indispensable asset with all her clients.

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Two ways to register for this event
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