RCM Benefits, Referrals & Prior Authorizations for Beginners



Master Referrals, Prior Authorizations, Benefits Verifications, and Authorization Denial Management in Medical Billing


What you will learn

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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

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