11/25/2025
📝 Eligibility Check vs. Prior Authorization — Simple Breakdown
Many claim denials happen just because clinics confuse these two important steps. Here’s the simplest way to understand the difference:
🔍 Eligibility Check
Verifies if the patient’s insurance is active and what services are covered before the visit.
✅ Prior Authorization
Payer approval required before performing certain procedures or services.
When your team gets these two steps right, your claims become cleaner, faster, and far more accurate.
AcerHealth helps practices streamline this entire process with efficient workflows and expert support.
Explore our services:
🔗 https://acerhealth.com/