Claims Denial

What Role Does Prior Authorization Play in Insurance Reimbursement?

Prior authorization might seem like just another administrative task, but for healthcare providers, it’s often the line between getting reimbursed and getting denied. As insurance companies tighten their rules, navigating this process has become more critical than ever—especially when it comes to protecting revenue and keeping the patient experience smooth. Key Takeaways Prior authorization ensures that services are medically necessary and covered by insurance, thereby helping providers avoid denials. In fact, insurance companies rely on it to manage costs and