Prior authorization is a process used by healthcare providers to obtain approval from insurance companies or government programs before they can provide certain medical services or prescribe medications. While it is an important step in ensuring appropriate and cost-effective care, it can also be a time-consuming and challenging process. Here are some common prior authorization…
Prior authorization (PA) is a process that requires healthcare providers to obtain approval from an insurance company before performing certain medical procedures, prescribing certain medications, or using certain medical devices. There are several reasons why health insurance companies require PA. First, it helps to ensure that patients are only receiving medically necessary care. Second, it…
Urgent Care as the name specifies are healthcare services that require immediate care for the patient. Urgent Care clinics/ facilities act as a bridge between the primary care physicians and emergency rooms. In short, the life of staff’s working in an Urgent Care clinic/ facility is fast phased and buzzes with activities. Due to the…
Ambulatory services are critical healthcare solutions that transfer patients to and from facilities providing continual care in the intermediatory transit. Typically a ambulance contains a stretcher, defibrillator, spine support boards, oxygen, oxygen masks, cervical collars, splints, bandages, a range of drugs, medication bags, suction units, intravenous fluids and several other equipment’s/ drugs/ that help in…
Clinical Labs services are spots of Health Care facilities that mostly do not interact with the patient except for the nurses who face the patient for specimen collection. Service providers who write the report/ do the tests on the specimens/ extract specimens etc need to be reimbursed for their services. However, they may not be…
The hospital/ facility is a hub for healthcare service where large number of patients seek medical services in various specialities at different time of the day. The facility may vary in size, specialities, services offered for treatments as per each individual organization, which can have a direct proportion to the staff and providers servicing at…
Insurance Benefit Verification in short (BV) is a process of verifying the patient’s active medical insurance coverage. The patient access team at the time of patient registration along with their other responsibilities such as appointment and scheduling, patient registration, collection and preparation of the EHR of patient/ insurance demographic details (face sheet), medical record preparation,…
As per federal government law the patient may not be refused healthcare services for emergency situations even if they do not have insurance coverage details. Patients register themselves as self-pay even when they do have an active healthcare insurance due to many factors such as When the patient is unaware of the plan coverage and…
The insurance discovery tool is a unique software created by combined expert Revenue Cycle Healthcare professionals along with state of art Artificial Intelligence. There are 15 algorithms used to discover the current accurate payer for the patient. This helps in extending retrieving capabilities to Medicare, Medicaid, Commercial and private payors. The software has the ability…
The Insurance Discovery software is a blend of knowledge from the medical billing industry veterans and state of art Artificial Intelligence technology. The combination spans about 15 algorithms that help in the search and retrieval of accurate insurance demographic for a particular Date Of Service. The tool has the ability to provide the effective date…