This lesson provides learners with an overview of the prior authorization process in dermatology.
Key topics include:
Understanding what prior authorizations are, how they differ from referrals, and why insurance carriers require them before certain services, procedures, or medications can be performed.
Identifying common scenarios that may require prior authorization, such as biologic medications, photodynamic therapy, and Mohs surgery.
Following the prior authorization workflow step by step—from verifying the need and gathering clinical documentation to submitting requests and monitoring case status.
Recognizing common mistakes such as submitting incorrect codes, confusing referrals with authorizations, or failing to check requirements ahead of time.
Learning best practices for documenting tracking numbers, communicating effectively with patients, and minimizing delays in care delivery.
By the end of this lesson, staff will understand how to support the prior authorization process and help ensure smoother, more timely care for dermatology patients.
Covers key elements like Member IDs, group numbers, and payer IDs, with detailed visual examples from insurers such as Anthem, Cigna, and Medicare. Includes best practices for verifying coverage, educating patients, and streamlining billing processes.
Improve payment processing and patient satisfaction with proactive, accurate eligibility checks. In this lesson, we review how to verify coverage, understand insurance responses, and communicate potential costs to patients.
Have confidence knowing that your staff will learn practical, "real-world" skills which are relevant to our specialty.
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