It has been a challenge to find a coding job as a newly certified CPC. I was fortunate to come across your informative video, which gave me a bit of insight to Prior Authorizations as an entry level job where I can start to put my skills to work. Very helpful! And you also made me LOL when you said, "Yeah, I'm serious! There's more, just hold on!" LOL, Thank you!
amazing video!! how do you go about navigating the different insurance guidelines for each patient? do you often just call the insurance to get these or refer to some guidelines online?
Thank you for watching! The best tools to utilize are the payer portals online. They have to be enrolled with an administrator (most of them) and then different users cat be assigned access using their own individual logins. Sometimes calling is necessary but starting with the portal is best.
Pre auth is really a ton of works in healthcare industry.. lot of claims are being denied because of failure by members/providers to include medical history or medical records. It is time consuming once your claims are denied.. so better assure to attach all medical records while submitting claims.
Yes, it is very sad how many claim rejection and denials are a result of not obtaining authorizations. Medical records should not need to be sent with claims if the authorization is obtained prior to services rendered, and the medical records being sent with the claim will not replace the need for an authorization either. Clinics definitely need to do their due diligence and understand what plans need these. I appreciate your participation on my video and for watching!!
@@shaktiranjanpanigrahi301 thank you for asking! It does vary based on the insurance, unfortunately. Great question and thank you for supporting my channel!
Yes, most Medicaid programs have strict guidelines on what they will and will not cover. Reviewing their online policies and guidelines help reduce unnecessary submissions of prior authorizations. Good luck and thank you for watching!
Hi there and thank you for watching my video! Unfortunately, you would have to have an authorization through the insurance company for any provider whom would be billing for services related to that patient. If you had a patient who saw a provider who performed the study and there was a different interpreting provider that was billing separately for that service, then you would need an authorization for both providers. I appreciate your support!
Informative👍
Thanks for watching!
You’re amazing! Thank you so much for sharing this information
You are so welcome! I hope you find it useful. Thank you for watching!!
It has been a challenge to find a coding job as a newly certified CPC. I was fortunate to come across your informative video, which gave me a bit of insight to Prior Authorizations as an entry level job where I can start to put my skills to work. Very helpful! And you also made me LOL when you said, "Yeah, I'm serious! There's more, just hold on!" LOL, Thank you!
Glad it was helpful and entertaining! Good luck on your new chapter. I appreciate the support!
This is truly amazing work thank you!
Glad you like it! Thank you for watching!
Very informative video, thank you❤
Glad it was helpful! Thank you for watching!
Great information! Thank you
Thanks for watching!
Very informative 😊 Thank you
Glad it was helpful! Thank you for watching!
Amazing video on the relevant topic 😍 thanks for making this video..
Glad you found it helpful. Thanks for watching!
Great!
Thanks for watching. I'm glad you found it helpful
amazing video!! how do you go about navigating the different insurance guidelines for each patient? do you often just call the insurance to get these or refer to some guidelines online?
Thank you for watching! The best tools to utilize are the payer portals online. They have to be enrolled with an administrator (most of them) and then different users cat be assigned access using their own individual logins. Sometimes calling is necessary but starting with the portal is best.
Pre auth is really a ton of works in healthcare industry.. lot of claims are being denied because of failure by members/providers to include medical history or medical records. It is time consuming once your claims are denied.. so better assure to attach all medical records while submitting claims.
Yes, it is very sad how many claim rejection and denials are a result of not obtaining authorizations. Medical records should not need to be sent with claims if the authorization is obtained prior to services rendered, and the medical records being sent with the claim will not replace the need for an authorization either. Clinics definitely need to do their due diligence and understand what plans need these. I appreciate your participation on my video and for watching!!
Is there any specific format in prior authorization number or it differs from insurance to insurance
@@shaktiranjanpanigrahi301 thank you for asking! It does vary based on the insurance, unfortunately. Great question and thank you for supporting my channel!
Thank you 😊
Thanks for watching!
Centen Medicaid thru nia is so strict in approving prior auth
Yes, most Medicaid programs have strict guidelines on what they will and will not cover. Reviewing their online policies and guidelines help reduce unnecessary submissions of prior authorizations. Good luck and thank you for watching!
I received denial due to different provider on auth vs different interpreting provider (sleep study). Anyone experience this?
Hi there and thank you for watching my video! Unfortunately, you would have to have an authorization through the insurance company for any provider whom would be billing for services related to that patient. If you had a patient who saw a provider who performed the study and there was a different interpreting provider that was billing separately for that service, then you would need an authorization for both providers. I appreciate your support!
I would like a template as guide ... To ensure that all my bosses are covered
Thanks for watching. I apologize but I don’t have a template to provide. Have you tried searching online for one?