Prior Authorization and Referral Tracking in Healthcare | Tips & Tools

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  • Опубліковано 20 гру 2024

КОМЕНТАРІ • 8

  • @itsirkeel
    @itsirkeel Рік тому

    Hi there! Another topic has come to me, one that feels especially 'slippery': billing MVAs/PIP. Especially when the person affected was a pedestrian hit by someone else in a car. Or a person on a bicycle hit by a car. Whose insurance pays first? What if the patient has private health insurance? What are the laws for who should pay in what order, how to write up an effective "you will owe the full amount within X time if you don't have an attorney" kind of protective letter, ALL of that!! It's so challenging as I haven't been able to find a place that teaches the flow chart of "if this, then that" for MVAs and PIP billing. Just wanted to put that your way!! Thank you for your channel, and helpful information, as always!! 😵‍💫

    • @navigatingthebusinessofmed8251
      @navigatingthebusinessofmed8251  Рік тому +1

      This is definitely a rough area to bill! I’m not too knowledgeable in this department but my mom works in a practice that does a lot of MVA and WC so I will pick her brain to see what I can find out. Thanks for the idea!

    • @itsirkeel
      @itsirkeel Рік тому +1

      @@navigatingthebusinessofmed8251 You're welcome! Even worker's comp seems more straightforward than MVAs, and I just don't see where I can get reliable, regionally-relevant training. And yet--- it's not uncommon. Maybe you can even do a quick discussion on the MVA state differences (at fault versus not) and that it's not quite as cut and dry as regular medical billing. If you do know about any training that is legitimate, I'd love to know!!

    • @navigatingthebusinessofmed8251
      @navigatingthebusinessofmed8251  Рік тому

      Unfortunately I don’t. I know my mom’s office understands Oregon laws for billing in these situations from trial and error over the years. Let me see what I can find! I’ll let you know if I find anything helpful.

  • @ClairePodoll
    @ClairePodoll 2 місяці тому

    Does Cover My Meds let you do this?

    • @navigatingthebusinessofmed8251
      @navigatingthebusinessofmed8251  2 місяці тому

      Cover My Meds does let you apply online and they interface with many EMR systems too. It’s a wonderful tool especially for making sure specific needed information is submitted for specific meds and payers. Thanks for watching!

    • @ClairePodoll
      @ClairePodoll 2 місяці тому

      @@navigatingthebusinessofmed8251 thank you so much! Do you know why for some medications on CMM information is auto populated and there seems to be extra support vs others are hard to track? Have you experienced this?

    • @navigatingthebusinessofmed8251
      @navigatingthebusinessofmed8251  2 місяці тому

      I’m not exactly sure but I think it has something to do with their system and what they know is always required for specific meds and insurances. When they aren’t sure, they leave it blank. Just remember the basics that are always needed (tried and failed drugs, why they failed, how long they tried them for, if they’re on any contraindicated meds, etc.) and then you’ll also learn what drugs also need other information from doing it. I know that’s how I learned.