What You'll Learn
- What referrals and prior authorizations are — and why they matter in healthcare
- How to verify a patient’s insurance eligibility and benefits step-by-step
- When and how to request a referral for a specialist or service
- How to submit prior authorization requests and what documents are required
- How to use payer portals, EHRs, and practice management systems for these tasks
- Common reasons for referral and authorization delays or denials — and how to fix them
- How to track your work using KPIs and SLAs for better productivity
- Tips and templates to improve communication with providers, patients, and payers
Requirements
- No prior healthcare or medical billing experience needed
- A willingness to learn and follow step-by-step processes
- Basic computer skills (using email, websites, and online forms)
Who This Course is For
- People new to healthcare admin
- Students starting a healthcare career
- Front desk or scheduling staff
- Medical assistants handling paperwork
- Support staff working with insurance
- Medical billers wanting front-end knowledge
- Clinic or hospital office workers
- Anyone curious about referrals and authorizations
Your Instructor
RCM Academy
Master Healthcare RCM & Medical Billing with RCM Academy
4.4 Instructor Rating
912 Reviews
12,992 Students
31 Courses
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