The Fundamentals of Prior Authorization


The Fundamentals of Prior Authorization, How to successfully obtain prior authorizations.

The Fundamentals of Prior Authorization will cover the following topics:

1. Prior Authorization Process

2. Team Members of the Prior Authorization Process

3. Insurance Payers

4. Medical Coding

5. Medical Terminology

6. Medical Records

7. Service Line Authorization Workflow

8. Service Line Authorization Fundamentals

9. Medication Line Authorization Workflow

10. Medication Line Authorization Fundamentals

11. Out of Network – Non-Participating Authorization


13. Ways of Submitting Prior Authorization

14. The Approval

15 Denials and Appeals

16. The Future of Prior Authorizations

These concepts will provide the student with complete understanding of what is needed to be successful in obtaining prior authorizations. This course goes in details about what is needed to obtain authorization for infusion therapy medications which is the most complex type of prior authorization requests. The student will walk away with the knowledge that is needed to land a job in various medical settings such as a doctor’s office, homecare, diagnostic and treatment center or a hospital. This course is also helpful for those who are in the field already and wants to improve their standard workflow. Also, job opportunities exist in which the student can work from the comfort of their own home obtaining prior authorizations. This course open for everyone. It does not matter if you are a nurse, a clerk or doctor or someone who never had experience in a healthcare setting.  As your instructor, I am very happy to share with you my knowledge and experience in this field. I would also like to take the opportunity in advance for thanking everyone who has made the decision to enroll in this course.

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