Purpose of Prior Authorization is to verify and obtain advance approval from the payer if a patient requires a specific service before it is performed. This process helps to ensure that necessary services are not denied to patients. Prior Authorization is an essential component in Revenue Cycle Management and Medical Billing; this also follows the procedure of determining insurance eligibility, proper payment collection for the provided services, and simultaneously lowering denials and A/R follow-up. Purpose of Prior Authorization in Medical Billing is to ensure that the billed services are provided and that the appropriate payments are made.

