Service Authorization Basics (Medicaid)
Service authorization is the process of obtaining confirmation from a patient’s insurance payer that the patient is eligible to receive their intended services or procedures. Neglecting to obtain pre-authorization for services can lead to denials, which negatively affect a provider’s revenue cycle. In this course, we explore the process of service authorization, best practices for confirming service authorization, and the effects of failing to obtain pre-authorization.
- Define service authorization and discuss its importance
- List the steps and components of service authorization
- Identify key aspects of a successful service authorization process
- Examine the implications of a poorly functioning or non-existent service authorization process
Advance Preparation: None
Program level: Basic
Delivery Method: Self-study
CPE Field of Study: Specialized Knowledge
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