How Prior Authorization Works (Or Doesn't)

Dr. Eric Bricker Explains the Prior Authorization Process Doctors, Hospitals and Facilities Go Through With Insurance Carriers to Have Certain Tests and Procedures Covered. Health Insurance Carriers Contract Out Prior Authorization to Vendors Such as 1) Evicore, 2) AIM Specialty Health, 3) NIA (Owned by Magellan) and 4) Health Help. Prior Authorization is Typically Required for Advanced Imaging (CT Scans, MRIs, PET Scans), Cardiac Imaging (Stress Tests, Echocardiograms), Cancer Treatment, Orthopedic Surgeries and Sleep Studies. Traditional Medicare Has NOT Had ANY Prior Authorizations Required Until Recently Putting in 'Appropriate Use Criteria' for Some Imaging. The Process of Prior Authorization is Cumbersome, Error-Prone and Time-Consuming for Doctors and Patients and Some Physician Groups--Such as the American College of Cardiology--Are Fighting Back. Sources: https://www.myndshft.com/the-ultimate... AHealthcareZ is 200+ Healthcare Finance Educational Videos. 💥 BOOK: Check out Dr. Bricker’s Book 16 Lessons in the Business of Healing here: https://www.ahealthcarez.com/healthca... AHealthcareZ Viewers Include: Employee Benefits Professionals, HR, CFOs, Insurance Brokers, Benefits Consultants, Doctors and Nurses in Leadership Roles, Hospital and Health System Administrators, Health Insurance Carrier and PBM Professionals, Pharma and Med Device Professionals, Academic Professors and Students in Healthcare Administration and Public Health. 90,000+ Views Per Month Across All Platforms. Visit AHealthcareZ.com to Subscribe to the Healthcare Finance Video Newsletter. #HealthcareCosts #HealthcareIndustry #PriorAuthorization