Contact Us

Prior Authorization Masterclass: Payer Rules, Common Pitfalls & How to Win Appeals

Prior Authorizations serve as a cost containment strategy that third-party payers leverage to control costs, restrict patient access to services, testing, and medications, and ultimately discourage medical providers from ordering unnecessary medical treatment.  Prior authorizations are a major source of headaches for healthcare providers across the country.

Despite the intention to control costs and ensure appropriate care, the prior authorization process has been criticized for its enormous administrative burden, potential delays in necessary medical treatment, and added complexity for healthcare providers.  Striking a balance between cost control and efficient patient care remains a major challenge in the healthcare industry.

Join us for an insightful 60-minute webinar as we take a deep dive into the complexities of the Prior Authorization process, discuss the pearls and pitfalls, define medical necessity requirements, and demystify the intricacies of obtaining prior authorizations, ensuring a smoother workflow and higher approval outcomes in 2025.

Webinar Objectives

  • Prior Authorizations are a key cost-containment strategy used by third-party payers to control healthcare expenses, but they often create administrative burdens for providers.
  • This session will address the complexities of the Prior Authorization process, offer insights into 2025 updates, and provide strategies to improve approval outcomes and reduce delays.

Webinar Agenda

  • Understand major Prior Authorization updates for 2025
  • Recall the role of medical necessity in the Prior Authorization approval process
  • Identify which insurance payers require Prior Authorizations in 2025
  • Review methods for obtaining Prior Authorizations in 2025
  • Recognize common challenges in the Prior Authorization process
  • Learn strategies for escalating and appealing Prior Authorization denials in 2025

Webinar Highlights

  • Discuss key updates to Prior Authorizations for 2025
  • Explore 2025 Prior Authorization requirements for Medicare Advantage Plans
  • Define medical necessity and its importance in securing Prior Authorization approvals
  • Review the regulatory landscape for Prior Authorizations in 2025
  • Identify insurance payers that require Prior Authorizations in 2025
  • Explore methods for obtaining Prior Authorizations in 2025
  • Examine common challenges faced during the Prior Authorization process
  • Share strategies for overcoming challenges with Prior Authorizations in 2025
  • Discuss how to escalate and appeal Prior Authorization denials effectively in 2025
  • Provide best practice compliance tips for successful Prior Authorizations in 2025

Who Should Attend

  • Medical Coding Specialists
  • Medical Billing Specialists
  • Medical Auditing Specialists
  • Private Practice Physicians
  • Managed Care Professionals
  • Operations Leadership
  • Practice Administrators
  • Office Managers
  • Compliance Officers/Committees
  • Chief Medical Officer
  • Medical Practices
  • Accountable Care Organizations
  • Medical Societies
  • Medical Associations
  • 60 Minutes

*Recorded webinar will be send to customer within the 2 working days after the Lve Webinar.

*For more than 6 attendee mail us to support@evothought.com

Laura A. Dixon recently served as the Regional Director of Risk Management and Patient Safety for Kaiser Permanente Colorado where she provided consultation and resources to clinical staff. Prior to joining Kaiser, she served as the Director, Facility Patient Safety and Risk Management and Operations for COPIC from 2014 to 2020. In her role, Ms. Dixon provided patient safety and risk management consultation and training to facilities, practitioners, and staff in multiple states. Such services included creation of and presentations on risk management topics, assessment of healthcare facilities; and development of programs and compilation of reference materials that complement physician-oriented products.

Prior to joining COPIC, she served as the Director, Western Region, Patient Safety and Risk Management for The Doctors Company, Napa, California. In this capacity, she provided patient safety and risk management consultation to the physicians and staff for the western United States.

Ms. Dixon has more than twenty years of clinical experience in acute care facilities, including critical care, coronary care, peri-operative services, and pain management.

As a registered nurse and attorney, Laura holds a Bachelor of Science degree from Regis University, RECEP of Denver, a Doctor of Jurisprudence degree from Drake University College of Law, Des Moines, Iowa, and a Registered Nurse Diploma from Saint Luke’s School Professional Nursing, Cedar Rapids, Iowa. She is licensed to practice law in Colorado and California