An Approach to Insurance Referrals and Prior-Authorizations: Centralization

The constantly changing world of prior-notifications for impending medical treatment has practices scrambling to meet the requirements being imposed on them by the companies that insure the vast majority of their patients. Medical practices must be nimble and forward thinking in order to meet these challenges and maintain financial stability, while still rendering high quality care and ensuring a satisfied patient base. Streamlining and centralizing the process for obtaining pre-notification is a fiscally responsible option to meet the growing demand for pre-notification of patients’ diagnostic exams.

MGMA does not endorse any solutions put forth in this paper. The Association urges readers to explore the legal issues – federal, state and local – that may arise from a particular course of action.