Prior-Authorization Challenges and Issues for Orthopedic Procedures

Event Information
Product Format
Prerecorded Event
Lynn M. Anderanin, CPC, CPMA, CPPM, CPC-I, COSC
Conference Date
Wed, Apr 29, 2020
60 minutes
Product Description

What’s Covered, What’s ‘Necessary,’ and What’s Eligible for Retro-Authorizations


Pre-authorizations are not optional for orthopedic procedures—they are mandatory business practice. But while common, the procedures can be complicated, oversight is high, and the bottom line is at stake. Don’t gamble with pre-authorizations—learn the facts and factors behind them.

Join senior coder Lynn Anderanin in this webinar to ready your practice to ace pre-authorizations and so you can become the office expert on the subject. Anderanin explains the difference between insurance coverage and prior authorization, the role of medical necessity, and the importance of eligibility processes before a patient is seen.

After attending this live audio event, you will know how to implement an eligibility plan in your office, reduce the number of retro-authorizations, and be able to apply insurance carrier guidelines to meet medical necessity. Don’t overlook this important step—learn its details to master its processes!

Session Objectives

  • How to implement an eligibility plan in your office
  • How to reduce the number of retro-authorizations
  • How to meet insurance carrier guidelines for medical necessity
  • How to obtain the most accurate prior authorizations for maximum reimbursement

Session Highlights

  • The problem of not obtaining appropriate authorization for office and surgical procedures
  • Pre-authorized procedures unlikely to be performed
  • What to do when the patient was not eligible for insurance coverage on the day the services were received
  • What codes are authorized in arthroscopy

Who Should Attend

  • Orthopedic surgeons
  • Podiatrists
  • Non-physician providers
  • Billers and coders
  • Claims reviewers and adjustors
  • Reimbursement specialists
  • Managers, supervisors, and administrators
  • Collections staff
  • Prior authorization staff
  • Surgery schedulers


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About Our Speaker

Lynn Anderanin - Orthopedic Guidelines Expert for ICD 10

Lynn Anderanin, CPC, CPMA, CPPM, CPC-I, COSC, is the  Sr. Director of Coding Education for Healthcare Information Services, a physicians revenue cycle management company. She has over 35 years experience in all areas of the physician practice, and specializes in Orthopaedics.  Lynn is currently a  workshop and audio presenter. She is a  former member of the American Academy of Professional Coders (AAPC) National Advisory Board, and has served...   More Info
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