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What is a pre-certification?
A pre-certification is a task performed by specialists in the healthcare industry and applies to health insurance and prior authorizations for procedures.
Pre-certification specialists play a very important part in managing a medical patient's care, this includes areas like costs of treatment, medication, and revenue cycle management.
Precertification specialists must have an in-depth understanding of various insurance policies and billing procedures to better organize, and ultimately streamline authorization processes. This enables them to provide patients with timely access to medication and treatment.
Here are the common duties of a precertification specialist:
Coordinating and confirming insurance plans and coverage
Confirming payments for prescriptions, procedures, and other medical services
Gathering information related to a pacific patient
Evaluating a patient's eligibility for a service
Communicating with insurance representatives to confirm eligibility and benefits for patients
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