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prior authorization

What Is Prior Authorization in Healthcare?

Prior authorization is a health insurance requirement that asks a healthcare provider to obtain approval from a health plan before certain medical services, prescription drugs, procedures, or medical equipment are provided. It is also called preauthorization, prior approval, or precertification. The purpose is generally to determine whether a requested service meets the insurer’s coverage or […]

medical billing

What Is Medical Billing? A Complete Beginner’s Guide

If you have ever visited a doctor, received a medical service, or looked at a healthcare invoice, you have probably encountered medical billing—even if you did not realize it. Medical billing is the administrative process used to communicate healthcare services to insurance companies and other payers, request payment, process claims, and determine what portion of […]