Deconstructing the 2024 Prior Authorization Process For Medical Providers
Prior Authorizations serve as a cost containment strategy that third-party payers leverage to control costs, restrict patient access to services, testing, and medications, and ultimately discourage medical providers from ordering unnecessary medical treatment. Prior authorizations are a major source of headaches for healthcare providers across the country. Despite the intention to control costs and ensure appropriate care, the prior authorization process has been criticized for its enormous administrative burden, potential delays in necessary medical treatment, and added complexity for healthcare providers.
Striking a balance between cost control and efficient patient care remains a major challenge in the healthcare industry. Join us for an insightful 60-minute webinar as we take a deep dive into the complexities of the Prior Authorization process, discuss the pearls and pitfalls, define medical necessity requirements, and demystify the intricacies of obtaining prior authorizations, ensuring a smoother workflow and higher approval outcomes in 2024.
Learning Objectives:-
Areas Covered:-
Background:-
Prior Authorizations are a critical cost containment strategy that third-party payers leverage to control healthcare expenditure costs, which can lead to frustrated medical providers, delayed medical treatment, delayed or missed diagnosis, etc.
Why Should You Attend:-
Prior authorizations are a major source of frustration and headaches for healthcare providers across the country. In this session, we take a deep dive into the nuances of Prior authorizations and how to successfully challenge and escalate denials.
Who Will Benefit:-
Any Organization, Institution or Group User can register
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Toni Elhoms, CCS, CPC, CPMA, CRC, AHIMA-Approved ICD-10-CM/PCS Trainer, is an internationally known speaker and recognized subject matter expert on medical coding, reimbursement, compliance, and revenue cycle management. She is the Founder and CEO of Alpha Coding Experts, LLC (ACE). She holds multiple credentials with the American Health Information Management Association (AHIMA) and the American Academy of Professional Coders (AAPC). Toni's expertise extends to inpatient and outpatient coding, compliance, billing, and reimbursement. She serves as ACE’s Senior Consultant and conducts training and educational seminars across the country. With over a decade of industry experience, Ms. Elhoms has led and supported hospital systems, universities, physician practices, payers, law firms, government agencies, and other entities on coding, billing, and compliance initiatives.
Toni is a frequent contributor to various media outlets, a highly sought-after conference speaker, and a regular guest on industry podcasts. She is frequently an expert and consulting witness in civil and criminal litigation matters. Ms. Elhoms was appointed as an editorial advisory board (EAB) member for The Coding Institute (TCI) in 2020. She created and regularly hosted the Alpha Coding Podcast series (rated a top industry podcast) to share her industry Pro-Tips. She is a regular volunteer and mentors a network of Revenue Cycle Management (RCM) and Health Information Management (HIM) professionals across the United States.
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