Prior Authorizations serve as a cost containment strategy that third-party payers leverage to control costs, restrict patient access to services, testing, and medications, and ultimately discourage medical providers from ordering unnecessary medical treatment. Prior authorizations are a major source of headaches for healthcare providers across the country.
Despite the intention to control costs and ensure appropriate care, the prior authorization process has been criticized for its enormous administrative burden, potential delays in necessary medical treatment, and added complexity for healthcare providers. Striking a balance between cost control and efficient patient care remains a major challenge in the healthcare industry.
Join us for an insightful 60-minute webinar as we take a deep dive into the complexities of the Prior Authorization process, discuss the pearls and pitfalls, define medical necessity requirements, and demystify the intricacies of obtaining prior authorizations, ensuring a smoother workflow and higher approval outcomes in 2025.
Webinar Objectives
- Prior Authorizations are a key cost-containment strategy used by third-party payers to control healthcare expenses, but they often create administrative burdens for providers.
- This session will address the complexities of the Prior Authorization process, offer insights into 2025 updates, and provide strategies to improve approval outcomes and reduce delays.
Webinar Agenda
- Understand major Prior Authorization updates for 2025
- Recall the role of medical necessity in the Prior Authorization approval process
- Identify which insurance payers require Prior Authorizations in 2025
- Review methods for obtaining Prior Authorizations in 2025
- Recognize common challenges in the Prior Authorization process
- Learn strategies for escalating and appealing Prior Authorization denials in 2025
Webinar Highlights
- Discuss key updates to Prior Authorizations for 2025
- Explore 2025 Prior Authorization requirements for Medicare Advantage Plans
- Define medical necessity and its importance in securing Prior Authorization approvals
- Review the regulatory landscape for Prior Authorizations in 2025
- Identify insurance payers that require Prior Authorizations in 2025
- Explore methods for obtaining Prior Authorizations in 2025
- Examine common challenges faced during the Prior Authorization process
- Share strategies for overcoming challenges with Prior Authorizations in 2025
- Discuss how to escalate and appeal Prior Authorization denials effectively in 2025
- Provide best practice compliance tips for successful Prior Authorizations in 2025
Who Should Attend
- Medical Coding Specialists
- Medical Billing Specialists
- Medical Auditing Specialists
- Private Practice Physicians
- Managed Care Professionals
- Operations Leadership
- Practice Administrators
- Office Managers
- Compliance Officers/Committees
- Chief Medical Officer
- Medical Practices
- Accountable Care Organizations
- Medical Societies
- Medical Associations
Toni Elhoms
Toni Elhoms, CCS, CRC, CPC, AHIMA-Approved ICD10-CM/PCS Trainer is a nationally known speaker and recognized subject matter expert on medical coding, reimbursement, and revenue cycle management. She is the Founder and CEO of Alpha Coding Experts, LLC. She holds multiple credentials with the American Health Information Management Association (AHIMA) and the American Academy of Professional Coders (AAPC). With over a decade of industry experience, she has led and supported hospital systems, universities, physician practices, payers, government agencies, and other entities on coding, billing, and compliance initiatives. She is a frequent contributor to various media outlets, speaker, and...
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