Prior Authorizations serve as a cost containment strategy that third-party payers leverage to control costs, restrict patient access to services, testing, and medications, and ultimately discourage medical providers from ordering unnecessary medical treatment. Prior authorizations are a major source of headaches for healthcare providers across the country.
Despite the intention to control costs and ensure appropriate care, the prior authorization process has been criticized for its enormous administrative burden, potential delays in necessary medical treatment, and added complexity for healthcare providers. Striking a balance between cost control and efficient patient care remains a major challenge in the healthcare industry.
Join us for an insightful 60-minute webinar as we take a deep dive into the complexities of the Prior Authorization process, discuss the pearls and pitfalls, define medical necessity requirements, and demystify the intricacies of obtaining prior authorizations, ensuring a smoother workflow and higher approval outcomes in 2025.
Toni Elhoms, CCS, CRC, CPC, AHIMA-Approved ICD10-CM/PCS Trainer is a nationally known speaker and recognized subject matter expert on medical coding, reimbursement, and revenue cycle management. She is the Founder and CEO of Alpha Coding Experts, LLC. She holds multiple credentials with the American Health Information Management Association (AHIMA) and the American Academy of Professional Coders (AAPC). With over a decade of industry experience, she has led and supported hospital systems, universities, physician practices, payers, government agencies, and other entities on coding, billing, and compliance initiatives. She is a frequent contributor to various media outlets, speaker, and regular guest on industry podcasts. She created the Alpha Coding Podcast series to share her industry Pro-Tips. She also leads and mentors a network of revenue cycle management professionals across the country and serves as the President of the Orlando, FL AAPC Chapter.