What is PCP, Specialist, Referral & Authorization - Basics of US Healthcare Chapter 2

My Name is Santosh Pant and I am a Certified Professional Coder in US Healthcare Revenue Cycle Services Process. I have started this channel for the people who want to learn Medical Billing, Medical Coding, or Account Receivable online. Let's learn together.
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[@Foodie_Monika]

Sir apki video ki wajh sey many claims main interview clear krliya hai Optum UHG company main thankyou sir🙏🥰apki sari video bhut achi hai sir.

[@SantoshPantCPC]

Made my day 🤗

[@ashishpokhriyal929]

Maam interview kaise hota hai plz baataye mai is line me jana chahta hun

[@Foodie_Monika]

@@ashishpokhriyal929 sir ney is video main jo bhi kuch start main btaya sab prepare kro or decide kro kismy jana hai many claims main diya tha....... Jismy Optum gurgaon main as fresher meri joining hui hai.

[@ashishpokhriyal929]

@@Foodie_Monika please help me for interview because i done diploma in electrical engineering sister plz 🙏

[@akky4892]

@@Foodie_Monika congratulations, AP kis post ke liye hire hue ho or interview me kis kis type ke questions puchte batado plZ

[@user-ux3tz1te9x]

सर आप हम जैसे गरीब लोगो के लिए किसी फरिश्ते से कम नहीं है I इतनी detail में कोई नहीं बताता, आपके द्वारा दी गई definitions को भी rat लिया जाए तो इंटरव्यू clear हो जाता है. Claim processing में भी बहुत help मिलती है

[@SantoshPantCPC]

I am one of you

[@jyotishisodeghanekar7472]

Very good explanation..I was not understanding training in my company about it by a foreigner..bt now after seeing im understanding and co relating it

[@Rahulno1mom]

Perfect explained by you sir....I really really thanks for your all videos.

[@anoopaggarwal6059]

Gud sir ,. Bahut easy way me samja rhe ho....

[@mgaikhangngam5039]

Authorisation description & explanation is little contradict, don’t you think?
I have been watching your videos whenever I have doubt n you never fail to delivered. One of the best channels for all those who wanted to start their career in US healthcare industry.
Thanks!

[@akshat2643]

exactly , authorization is taken from the insurance companies by the pharmacy or providers before a major surgery.

[@movierulz_in6042]

Very helpful santhosh
I have joined AGS health as an AR caller but I am not able to understand the training part so what I have done is I have been watching your videos from last 10 days and now I am quick answerer in the training batch😊 your uploaded videos helped me alot
Please santosh try to make a full AR caller training module so that it can help the trainee to understand better than the trainer explaining in the room

[@NirajYadav-ms1co]

very help full video and proper explanation

[@nishapant-b8v]

Excellent ! Well explained

[@SSviralworld]

Thanks Mr. Pant I have cleared all of my basics and your videos are very helpful keep going on great job 🙏

[@YogeshSharma-um3ov]

You are awesome sir :) I used to learn so many things from your videos. Hats off to you!

[@sachinbhandari1101]

Nice video help ful

[@deep8utube]

Pant ji, thank you for providing valuable information in simple words.

[@AmitKumar-uq3js]

Really knowledgeable...
Great..👌 👌
Keep it up.. 👍 👍 👍 👍

[@akshat2643]

Am going to clear interview after watching your videos.

[@MuhammadBilal-wf1qp]

Sir you are doing a great work god bless you!❤

[@vipinkumar-ed8fe]

Good 👍

[@gurwinderbadali9418]

I got selected in US medical billing process thanks for this content sir 🙏🙏

[@nuruladnan8382]

Gurwinder ji kya aapka number mil sakta hai mujhe?
Kuch zaroori cheez puchna hai aapse
Please aap apna number zara share kijiye. Mujhe medical billing k barame aapse bath karna hai.

[@ima_Rahul]

Superb. I am preparing for my BA interview from your video

[@santoshchaturvedi4175]

Bheji 😀... Bht bht dhanywaad 🙏🏻🤗

[@yogeshkumar2300]

Nice information.

[@pia_logophile]

Thnks for making these videos. It's help me alot my preparing for interview and lot's of question are retable

[@anujchauhanofficial2071]

You are unbelievable..how can someone can give such a good knowledge in a very simple way ❤️🙏🏻

[@dishasharma7782]

Thanks for sharing such a informative content, Please upload videos on ICD , CPT, E&M, HCPCS for fresher medical coders.

[@rajeshwaritripathi4070]

very useful all your classes and knowledgeable !!

[@MANOJSINGH-eb8pp]

Great explanation

[@ansari409]

Please share IPA video. Indipendent provide association and also explain about pre determination

[@prativamohanty2784]

Thank you for all ths video.. Really helpful

[@karan02011972]

You explained us in a very simple language , i give you 100 thumb up.

[@ashokbuggapally9288]

Yes

[@alisayababbasi1851]

Good work sir. I have learnt alot from your videos. Best wishes ahead

[@nitinnegi8171]

Love your videos iam also working as Ar

[@prateekdubey3154]

very good initiative,,, I have subscribed your channel successfully,,,
Please give a very good and short definition of PPO and HMO and also ensure how it works,,, I will be much awaited for the same...
right now I have two years experience of payment posting in UHG... I am a fresher here in medical billing field and now looking forward for a better opportunity..

[@SantoshPantCPC]

Thanks Prateek...type if insurances will be covered soon under basics...Keep watching the channel and share to your friends also so we all get all the information at one place. Best of luck in the industry.

[@Naveenkumar-fd1zd]

Your explanation is easy way thank you

[@uk8625]

So much helpful videos

[@sourabhmane8122]

Great explanation 👍🙏

[@cravenmunch]

Best efforts sir.

[@vipinkumar-ed8fe]

Nice

[@parwezalam4058]

Thanks sir for sharing knowledge 👍👍👍

[@AjaySingh-fs6no]

Thanks for sharing this information 🙏

[@deepdeewan1184]

Very easily you taught us..thank youuuuuuu..

[@sumerakhan2031]

Please explain about adjustment, write off in medical billing, why we do adjustment,

[@crystalcalmingrelaxingmusi8291]

Job role- as a Analyst, you will work as a mediator between the company and clients. You will be checking the compliances for denied claims. And work on those claims settlements. Can u explain this how to work

[@harshit-hd5ee]

We check authorisation in inpatient or outpatient

[@7465Prince_]

Sir please make a video for difference between Authorization, Prior Authorization and Retro Authorization

[@gayathrirajesh5885]

please upload videos on Benefit Configuration and related

[@Naveenkumar-fd1zd]

Thank you so much sir it is very helpfull for interviews

[@anuragmore492]

Which is the best company to starts carrier in medical billing?😊

[@lgh12344]

Sir one point I am confusing, the authorization numberl is issue by the patient insurance or the PCP ?

[@rahimkhan3513]

Am going to starting my career in us healthcare sir

[@nitinsawant7911]

Santosh please please one video on ppo hmo epo open access plus..pos explanation

[@shanthun4496]

I need a full explanation of suspended and pre suspended part in Authorization...can u pls explain...

[@waseemsajjad8724]

Retro Authorization and perior Authorization be esi ky sath include kr dana chayie tha

[@Pankajsharma-rb3nd]

Hello sir, plz make a video on insurance enrollment, and also cover all topic of enrollment jaldi video bnana sir mera interview hai plz sir

[@Untoldstories-d9s]

Thanks again

[@Being_Harry]

Does a PCP has to be contracted with Insurance?

[@shashidhar3113]

Big salute sir,🙏

[@niladrisamanta7712]

Can you please explain in the network and out network of Authorization ? What is the difference between Referral and Authorization ?

[@poonamdesai8432]

Referral...where PCP referes to patient to the specialist with specific Referral number and authorization means getting a permission from insurance to provide high dollar of medical treatment to the patient

[@moirangthemvishalsingh]

Thank you can you video on all the different scenarios it will be very helpful

[@gayathrirajesh5885]

please upload videos of RCM

[@sameerkale7282]

What is order, documents, comment , allergies and results in us healthcare system?

[@MicDrop21]

Agar koi emg specialist hai to kya jaruri hai wo jo bhi patient seen karega wo kisi pcp ne refer kie honge? Please answer

[@anuragmore492]

Are you working in gebbs health care solutions?

[@Theoneride]

@santosh pant CPC
Do you Sarvan?

[@rehankhan-cw3kj]

Sir
Anesthesia pr bhi videos Bnaiye

[@sangitaroychakraborty417]

What is Ty he difference between prior auth and pre d?

[@ayyappagowdabiradar471]

Hi Panth, what kind special office visits need authorization

[@amjadali8080]

Sir agar Ek ee date pe me Dr. Ko Dekhaonga to uski Paiment aegii
Unky koii codes hongy..
Same doctor & different doctor k liye kya use hogga time ya ??

[@anantmishra1782]

Sir FCC kya hota h

[@hemantgawade8223]

Thank you ☺️☺️☺️☺️☺️

[@saraswathigangotri7884]

Thank u sir

[@manunaik4817]

Thank you sir.

[@sumerakhan2031]

Can you please explain about tier 1 and tier 2 in VOB,s.

[@sangeetaprajapati100]

I'm working in medical billing..in AR and denial process

[@amanbansal4254]

I have one question.
If provider/Patient didn't take prior authorisation, and now insurance denied the claim. In this case who we we will pay this claim? Will patient pay full claim amount to physician/Hospital?

[@SantoshPantCPC]

Thats a really good question as we often confuse who is actual responsible. Well usualy insurance tells that if that is patients responsibility or Providers by giving a denial code with CO or PR. Sometimes it depends on Providers will if they want to bill patient or adjust.

[@amanbansal4254]

@@SantoshPantCPC Thanks Santosh gor replying.. I think it should be written off because it was provider responsibility to get authorisation before provide service to customer.
Once again thanks..

[@goldengal1990]

@aman bansal will not written off directly ..if therebis no auth..we have to ask for retro authrization , if not possible we have to go for appeal

[@amanbansal4254]

@@goldengal1990 thanks

[@ruksarkhan3595]

Santosh address ,uhc I'd ,panels ,supervising specialty pe video's banao

[@arpansharma5654]

Sir AR ke liye bhi inhi video ko dekhnaa hai

[@hasnainabbas7237]

👍

[@ravitejamargam7698]

I don’t know Hindi. Is there any plan to make content in English??

[@Street__pixelss]

Sir Medicare full topic and CED full information

[@hackingpanchal8283]

I need sum video of coinsurance and diductable

[@AnilKumar-gl9ny]

Thanku sir

[@niteshdhankash5577]

I have 4 -5 year of experience in us healthcare and disability insurance but I want to join medical billing or AR companies as there is vast opportunities and security of job ..but the thing is I have different knowledge and do not have prior experience of medical billing can you please help me to get a job in these respective companies any trick or method to land a job ....will be greatful to you ..your content are remarkably excellent..thanks

[@ranjan91222]

Sir I want do cpc any guidance?

[@riteshghosh8229]

Thank you Bro. I have 4 years of experience in DME and Anestesia Billing. I have interview for physician Billing. Can you please help me how to take preparation for that di u have any pdf for that?

[@abhijitghosh9280]

Thank you

[@jayveebilgera7117]

i found this video very helpful, but atleast you speak English or put subtitles so we understand clearly bro.

[@niharbarik1098]

Thanks sir

[@optimusfox7480]

Hi Sir! How we can link the claims for reconciliation? Please help

[@saifalam305]

Hello sir
What is different bw skilled nursing facility and nursing facility.
Plz give me response I am confused.

[@meditationvideos2360]

Yes

[@mukeshmehra42]

Sir I work in appeals department as a cordinator so can you make some video regarding that

[@aquibx]

you are in Most simplest process in AR😂...enjoy with your appeal packet..keep faxing or mailing😂...

[@shrutibajaj7211]

Authorization is required for urgent surgeries ??

[@SantoshPantCPC]

Exceptions are there

[@AshwinKumar-kc7ly]

Who submits the Claims? Is it Provider? If so then what is the need for Authorization?

[@aquibx]

Nope....Providers/Facilities hired Biller (Companies where you will working as in AR or Biller) so Claim was submitted by you.

[@KavithaAnu0210]

Sir need abt payor class

[@priyankasingre1735]

Is referral diagnosis code specific? Or if a referral is approval for "X" diagnosis code that means it can be used for any "A, B, C etc" DX code?

[@poonamdesai8432]

There is difference between refferal and dignosis codes

[@hrown5010]

Could you make a video on Revenue Cycles Management
Bcs this is a lengthy topic and it is difficult to understand so if posssible could you explain in your own words it would be easy for me.

[@SantoshPantCPC]

pls see my first video chapter zero if it can help

[@soniraj3700]

Sir is job ke liye kya qualifications honi chahiye

[@rohankmr963]

Please how can i get cpc certificate. Which institution would be good for preparation.

[@SantoshPantCPC]

I did from Genus Healthcare

[@sarojapawar7553]

Sir I wanted to do coding course I stay in Bangalore can u suggest any good course or tutorials?

[@SantoshPantCPC]

connect with Genus Healthcare 9911593677

[@user-ux3tz1te9x]

Love you sir