Expert Guide · RCM
Payer & Prior Authorization
Payers set the rules; disciplined providers still win. Building payer relationships, mastering prior authorization, and protecting reimbursement.
In This Guide
01
Building productive payer relationships
The why and how of forming payer relationships that shorten disputes and improve contract performance.
02
Prior authorization best practices
The workflows, worklists, and auto-status tooling that keep authorizations from delaying care and payment.
03
Common prior-auth pitfalls
The traps — retro-auth gaps, expired windows, mismatched codes — and the checkpoints that catch them.
04
Special reimbursement cases
Motor vehicle accidents and other third-party liability claims: getting paid when the payer is not an insurer.
Go deeper on this topic
All resourcesFrom the library
How Hospitals Can Win the Payer Game
Read article
From the library
Why Prior Authorizations Are So Important
Read article
From the library
Strengthening Payor Relationships
Read article
Put It Into Practice
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