Prior-Authorization

Outsourcing Prior Authorization Process: An Approach to Optimizing Your Revenue Cycle and Improving Patient Care                                        

Author: Dr. Aamer Nawaz Syed, Pharm. D Prior Authorization Specialist at Staffingly, Inc. What is Prior Authorization? It is a health insurance company utilization management approach that requires certain operations, tests, and drugs ordered by healthcare practitioners to be assessed for medical necessity and cost-of-care implications before they are permitted. A health insurance payer’s choice to approve or reject a prescribed course of treatment based on the results of a prior authorization review will influence whether a provider or pharmacy