Credit Balances
Managing credit balances, where providers receive more money than billed, is critical. Identifying overpayments and promptly refunding them is essential
Patient Statements and Follow-Ups
The final phase involves patient collections, including follow-ups on delinquent accounts through statements, communication, and offering convenient payment options. Payments
What to do if PA is denied?
Patients can appeal denied claims by contacting the insurance company, fixing errors, providing additional information, and working with the physician
Duration of prior authorization
The PA process can be time-consuming, with physicians spending hours on it. Responses from insurers can take up to several
Common reasons for PA denial
Denials may occur due to insufficient time for processing, billing errors, outdated information, lack of medical necessity, inadequate evidence, wrong
Steps in the pharmacy prior authorization process
Physician prescribes a drug. Pharmacy notifies the physician if PA is required. Patient can wait for insurance approval or pay
