Pre Certification and Prior Authorization

Pre Certification is permission given by Insurance to the Provider stating they will render or perform the service but doesn’t guarantee payment. Pre Authorization or Prior Authorization may be a written statement provided by the Insurance asking a provider stating they will render the service and provides a guarantee for a reimbursement.

A physician preparing and holding an insurance

Understanding the Pre-Authorization

Pre-Authorization is the process of getting the prior approval/notification for a service from the insurance carrier. Obtaining proper Pre-Authorization, before the service leads to prompt payment and reduces write-offs. It is a decision from health insurance or plan that a health care service, treatment plan, prescription or durable medical equipment is medically important. We also call it as prior authorization, prior approval or precertification. Your insurance or plan may require preauthorization surely services before you receive them, except in an emergency. Preauthorization isn’t a promise your insurance or plan will cover the value.

Obtaining proper Pre-Authorization

Importance of Pre-Authorization

Insurance Pre-Authorization is the very initiative once the patient schedules for a meeting. This process is the best method to lower the denials from the payer resulting in increased revenue. Patient benefit verification provides detailed information to the provider on the reimbursement and therefore the patient liabilities.

Prabill is run by a chiropractor who wants to help other chiropractors with their billing needs. We work hard every day in order to provide our clients with effective billing solutions. Feel free to contact us in case you need any help. Fill out the contact form or you may call us at (714) 733–8667 or email steve@prabill.com to schedule a callback.