The Course

Hey there, healthcare warriors! Are you ready to dive into the nitty-gritty of prior authorization and streamline the process like a pro? This course is going to be your blueprint, guiding you through every twist and turn of the prior authorization maze. You'll learn all about navigating insurance policies, mastering the art of submitting accurate requests, and advocating effectively for patient access to necessary treatments. We'll break down the complex interplay between healthcare providers, insurance companies, and the most valuable stakeholder our patients! This course ensures you come out knowing every step required to secure timely patient authorization efficiently and correctly.

What's more, you'll walk away with super practical skills that you can put to use immediately. Imagine being the go-to person in your medical practice or hospital who can cut through red tape with superhero speed! We're talking about real-world scenarios where you get to save the day by ensuring patients receive their treatments without unnecessary delays. Say goodbye to claim rejections and hello to seamless healthcare delivery after you ace this course. Join us, and let's transform the daunting task of prior authorization into your secret weapon for outstanding patient service.


What you will learn

When crafting this program, I kept in mind how daunting the world of prior authorization can feel when you're just stepping into it. That's why I've put together a comprehensive guide that'll take you by the hand through the complexities of insurance policies, medical necessity criteria, and efficient billing and documentation practices. You'll find the content not only informative but also highly structured, ensuring you can navigate through each module with ease. This course will provide you with the practical skills and confidence to manage prior authorization requests seamlessly. I've sprinkled real-life scenarios throughout, so you'll be well-prepared to tackle any challenge the healthcare setting throws your way. Plus, we've made sure to include plenty of resources and tools, so you're never left high and dry. Whether you're aiming to boost your employability or just wanting to remove the headache from insurance paperwork, this course is your roadmap to becoming a pro at securing those crucial authorizations.


Curriculum

  Introduction
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  Understanding Prior Authorization
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  Navigating the Prior Authorization Process
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  Strategies for Optimizing Prior Authorization Workflows
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  Ensuring Compliance and Regulatory Understanding
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  Case Study Example and Continuing Education
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  Conclusion and Next Steps
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Your instructor

Tiffany Robinson brings to the table a vast expanse of expertise honed over two decades in the Medical Claims Industry, with a concentrated focus on the challenges and nuances of Outpatient and Ambulatory services. Launching her vocation as an eager intern at just 17 at SUNY Downstate Medical Center, she rapidly ascended to pivotal roles, including spearheading the claims oversight for a multitude of multi-specialty providers as the lead medical biller in the Department of Medicine. It was in this capacity that she also became the mentor for incoming billing staffers, ensuring they were fully versed in the intricate web of departmental protocols.

Now serving as a Director of Operations in Revenue Cycle Management, Mrs. Robinson marries her invaluable field experiences with solid academic foundations. Tiffany holds an Undergraduate degree in Healthcare Administration and multiple certifications, including a specialization in Medical Coding from AHIMA and Clinical Documentation from AAPC. A relentless advocate for continual education is verified by further credentials in Law Leadership within Healthcare from the Mitchell Hamline School of Law. Tiffany Robinson aka "Coach Tiff' demonstrates she is not just a practitioner but a passionate educator. In her classes, Tiffany doesn't just impart knowledge; she instills a practice of lifelong learning, fostering a deep understanding of the meticulous and often complex prior authorization landscapeā€”a crucial element for ensuring financial viability and patient-focused care in the ever-evolving healthcare system.

Comprehensive

A Deep Dive into Streamlining Procedure Approvals!

Strategic

Optimizing Processes for Successful Coverage Decisions.

Essential

Optimize your approval process with actionable insights and Best Practices!