Obtaining Prior Authorizations

[@meadowrose100]

This is the first time I've seen your channel, with the exception of one other video watched today. I worked as a medical receptionist for 10-1/2 years and am hoping to get back into that field. I appreciate the videos you've put out so far. Thank you for sharing this content!

[@navigatingthebusinessofmed8251]

Thank you for watching and how exciting. I wish you luck getting back into the field. Here is the link to my blog posts on my website that may assist you with getting your feet wet again. integralclinicsolutions.com/blog/ I appreciate your support of my channel!

[@beasaroze5596]

Hello, I am an EHR student and your video is part of our class.

[@navigatingthebusinessofmed8251]

That's great! I am flattered. I appreciate it very much! Which EHR if you don’t mind me asking?

[@laryramos-d7k]

I really wanna learn how to do PA step by step. On my work we have a MA doing the PA but most of the time the office is behind on the patients medications because he work on front office checking in patients. Can you provide the steps to do the PA?

[@navigatingthebusinessofmed8251]

That is a great idea for a video, however every clinic may do it a bit differently. I can at least review what will be required no matter what so the information can be used no matter the ways in which the PAs are obtained. Cover My Meds is a great portal and you should see if your MA uses that so you can get access. Thanks for the idea and thank you for watching!

[@erinellis6323]

My advice is to JUMP IN! Biologics Coordinator here. When I first started, I would literally call the pt's insurance (phone # on back of card) and tell the Rep what drug I'm looking to get approved, then ask what the fastest method is for that pt/plan. Typically, PAs can be done by phone, fax, or (preferably) an online portal like CoverMyMeds.

[@rcm313]

Can out of network providers obtain prior authorizations? Appreciate if you can share your email address as well.

[@navigatingthebusinessofmed8251]

Hi there and thank you for watching! Generally out of network cannot obtain prior authorizations or referrals unless there are unique circumstances and that is rare. Sometimes out of network providers can be authorized to treat a patient as in-network but that is usually rare and on a case-by-case situation. All insurances are different so you would want to check their individual policies. My email is [e-mail]. Happy New Year!