JCH&L Staff Certified in Prior Authorization

Jefferson Community Health and Life staff members Kayla Young, Tiff Bartels and Jasmine Schwisow are now certified authorization specialists, through Accreditation Council For Medical Affairs (ACMA), The Prior Authorization Certified Specialist (PACS) Program.

Schwisow, patient access manager, said the education will be an asset for JCH&L and its patients.

“The training will help us to ensure that we are getting services covered and approved from insurance so everyone can have a peace of mind,” Schwisow said.

The 12-module program covered:

Prior Authorization Understanding

What prior authorization is and how it came to be utilized across the industry

Insurance Policies and Payment

A comprehensive understanding of health insurance for federal, state, and commercial plans as well as pricing, drug tiering and copay assistance

Compliance

Compliance standards relevant to any professional working in reimbursement and access

Processes

Important functional areas within Medical Affairs, such as compliant publication practices, advisory boards, continuing medical education, investigator sponsored research, and post-marketing studies

Barriers to Access

Essential resources and education to develop the skills needed to handle denials and work towards claim resolution

“This program gave us a lot of great material and knowledge we have not learned before. This course explained not just the ‘why’ of the process, but the importance of all the pieces that make up the why,” Schwisow said.

Anyone with questions about prior authorization of services can contact Schwisow at 402-729-3351, extension 4611.