Master Referrals, Prior Authorizations, Benefits Verifications, and Authorization Denial Management in Medical Billing
What you will learn
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What referrals and prior authorizations are — and why they matter in healthcare
How to verify a patient’s insurance eligibility and benefits step-by-step
When and how to request a referral for a specialist or service
How to submit prior authorization requests and what documents are required
How to use payer portals, EHRs, and practice management systems for these tasks
Common reasons for referral and authorization delays or denials — and how to fix them
How to track your work using KPIs and SLAs for better productivity
Tips and templates to improve communication with providers, patients, and payers
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