RCM Benefits, Referrals & Prior Authorizations for Beginners

Course Overview

• Course Title: RCM Benefits, Referrals & Prior Authorizations for Beginners
• Instructor: RCM Academy
• Target Audience: Beginners with no prior healthcare or medical billing experience
• Prerequisites:
  • 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)

Curriculum Highlights

• Key Topics Covered:
  • Understanding referrals and prior authorizations
  • Verifying patient’s insurance eligibility and benefits
  • Requesting referrals for specialists or services
  • Submitting prior authorization requests
  • Using payer portals, EHRs, and practice management systems
  • Common reasons for referral and authorization delays or denials
  • Tracking work using KPIs and SLAs
  • Communication tips and templates
• Key Skills Learned:
  • Fundamentals of referrals
  • Authorization workflow management
  • Patient eligibility and benefits verification
  • Setting up productivity metrics
  • Using healthcare tools and systems
  • Handling denials and follow-ups

Course Format

• Duration: 3 hours on-demand video
• Format: Self-paced online course
• Resources:
  • Access on mobile and TV
  • Certificate of completion