Health insurance companies require prior authorization for the payment of services that are provided to patients. Similarly, in skilled nursing facility billing, prior authorization serves as an important contributor towards effective reimbursement and reduced claim denials. Even with all the other billing methods in place, claims for services requiring authorization may be denied or delayed if prior authorization requirements are not met. Thus, it is important for every skilled nursing facility to know the secrets of prior authorization, and how it can increase or decrease your revenue. A step-by-step analysis of PA in skilled nursing facilities Before discovering the secrets of prior authorization, let us understand how it functions in the billing process. 1) Patient identification: Patients are referred to the SNF by physicians or doctors. The referral is initiated when the patient is discharged from a hospital and requires: Rehabilitation servic...
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