Since I have been working for the last 6 years as a Prior Authorization Specialist in the field of Genetic Testing, my work around usually begins with checking for any urgent or stat cases. If there's none, I will then proceed on checking if I receive either a blood sample or a Prior Auth request form from the doctor's office and making sure all the necessary codes (CPT Codes, Dx codes, insurance info, clinical info) were already attached in our database. Once completed, I'll check the time zone/s of patient's insurance before calling to get benefits and eligibility and might as well the possibility to submit an auth along side with patient's clinical. Depending on patient's type of insurance whether genetic counselling should be conducted before Prior Auth submission. Let's ideally it's ready to go, we'll be submitting Prior Auth and will call to check it's status and future decisions.
