Aug 16, 2011

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Preauthorization Obtained But Not Honored?  Utilization Review Standards Can Improve Preauthorization Appeals

When medical preauthorization is not honored, it is often up to the billing professional to determine why.  Where should you start?  First, know the law.  State utilization review laws vary considerably. Some states require carriers to. . . .

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AppealLettersOnline.com Featured Appeal Letters

AppealLettersOnline.com now features a sample appeal letter for appealing a carrier’s precertification or preauthorization reversal.  The following letter is located in the appeal database under the Topic: Medical Necessity and the Subcategory: Case Management Standards: Reversal of Certification Determinations

Access the appeal letters at AppealLettersOnline.com


Obtaining The Authorization:  Preauthorization Process Improvement Tips That Work

Does your practice have certain procedures, medical devices and/or medications which require extra preauthorization effort? If so, it is likely that your preauthorization requests process can be improved with detailed focus on. . . .

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