precertification

What is a Prior Authorization and Why is it Important

What is precertification, prior authorization, or pre-approval? Today, many procedures and diagnostic tests, regardless of provider specialty, require prior authorization, but what exactly is it, and why do you need it? A prior authorization request provides information to the insurance carrier, who then will provide written confirmation that the procedure or diagnostic test can be …

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Prior Authorizations for Cardiologists

Prior Authorizations for Cardiologists: Everything You Need to Know 

Cardiology practices face some of the biggest burdens when it comes to obtaining prior authorizations for necessary diagnostics and procedures. Today, everything from Echocardiograms, Dopplers, and Ultrasounds, to procedures like Cardiac Catheterizations and Stents require prior authorization. Interventional Cardiologists face an even higher burden when it comes to precertification requirements, often requiring patients to return …

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Precertification Request

How to Create a Precertification Request

Prior authorization requirements for diagnostics and procedures are evaluated on a case-by-case basis. There are no streamlined requirements for prior authorization among the various insurance carriers, and each case must be processed individually. For carriers requiring prior authorization, it may be obtained by phone, web portal, or other submission methods depending on carrier requirements. In any of …

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