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    Lead • Influence • Transform

    Market Access & Field ReimbursementExecutive Leadership Summit

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    Rated #1 Prior Auth CertificationRated #1 reimbursement, market access & prior authorization certification program

    Official reimbursement & prior authorization certification for healthcare and life science professionals

    Become a leader in Prior Authorization

    Reinforce experience and upskill

    Be best in class

    Enhance patient access

    I want to certify my staff or team

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    The Prior Authorization Certified Specialist (PACS®) Program

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    95% Rate PACS good to excellent

    44%
    improvement in prior auth approvals
    2.9
    days reduced from the time between the first prior authorization request and approval
    60%
    reduction in the amount of time spent supporting each single prior authorization request submission
    55%
    improvement in Prior Auth submissions
    PACS Badge
    44%
    improvement in prior auth approvals
    2.9
    days reduced from the time between the first prior authorization request and approval
    60%
    reduction in the amount of time spent supporting each single prior authorization request submission
    55%
    improvement in Prior Auth submissions

    PACS® professionals from over 250+ companies

    • GSK
    • ABBVIE
    • UCB
    • Neurocrine
    • CARDINAL
    • AETNA
    • CVS
    • WALGREENS
    • sanofi
    • TAKEDA
    • PACS

    • Why PACS ?

    • Price Info

    • Reviews

    • Curriculum

    • PACS FAQs

    • PACS

    • Why PACS ?

    • Price Info

    • Reviews

    • Curriculum

    • PACS FAQs

    The Prior Authorization Certified Specialist (PACS®) Program

    The Prior Authorization Certified Specialist (PACS) program is the only program focused on the information necessary to be a successful access and reimbursement professional.


    Format

    100% online and self-paced for your convenience

    Exam required

    Yes, 4 attempts provided (online)

    Time to complete

    6 months (average completion time is 10-12 hours)

    Support provided

    24/7 live human chat avaliable

    PACS® - Transforming patient access, prior authorization & reimbursement

    The authority on prior authorization

    What you need to know about PACS

    • It's the only accredited certification program for prior authorization, reimbursement, market access and payer policies recognized in the industry. Watch a 1 minute video explainer about PACS

    • Created for prior authorization specialists by prior authorization specialists with experience in PBMs, payers, pharma, and healthcare.

    • ACMA established the industry standard with the PACS certification - ensuring core competency for authorizers.

    Take the first steps towards achieving the gold standard in the healthcare and life sciences industry.

    Be more than an authorizer

    The Prior Authorization Certified Specialist (PACS) professionals are expanding patient access, advocating for better patient outcomes, and leading the reimbursement and access industry.

    • Establish yourself as an expert in prior authorization

    • Increase your effectiveness while making a difference

    • Demonstrate mastery of the prior authorization and payer landscape of the healthcare system

    The path to becoming an exceptional reimbursement and access professional starts with PACS.

    Why should I become a Prior Authorization Certified Specialist?

    Credibility

    Earn the recognition of achieving the standard of excellence among reimbursement professionals

    Expertise

    Prior Authorization Certified Specialist professionals are leaders and subject matter experts among their reimbursement peers

    Dedication

    Prior Authorization Certified Specialists demonstrate a commitment to patient access and better outcomes

    Higher pay

    Certified professionals earn higher pay compared to other professionals in the field

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    ANSI Logo

    The PACS® program is accredited by the International Accreditors for Continuing Education and Training/American National Standards Institute (IACET/ANSI)

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    95% rate PACS good to excellent

    PACS® payment options

    PACS certification demonstrates your mastery of the highest standard of knowledge through experience, rigorous study, and evaluation

    Full Payment

    Prior Authorization Basic Training Program (PABT)

    $1,299.99

    for prior auth beginners


    6 month access (online)

    12 learning modules

    12 pre & post knowledge checks

    Resources & case studies

    Final exam (4 attempts)

    PACS credentials

    Full Payment

    Best Option

    The Prior Authorization Certified Specialist (PACS®) Program

    $1,499.00

    for Reimbursement, MD, PharmD, & PhD Professionals


    6 month access (online)

    12 learning modules

    12 pre & post knowledge checks

    Resources & case studies

    Final exam (4 attempts)

    PACS® credentials

    3 Month Installments

    The Prior Authorization Certified Specialist (PACS®) Program

    $524.65 / 3 monthly

    Please email info@acmainfo.org for more information regarding installments.


    6 month access (online)

    12 learning modules

    12 pre & post knowledge checks

    Resources & case studies

    Final exam (4 attempts)

    PACS® credentials

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    Don't take our word for it.

    Trust our customers

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    The PACS program truly opened more remote prior authorization opportunities for me, allowing me to expand my career in ways I hadn't imagined. The contents I learned in the PACS program truly set the foundation and helped me be a step ahead in my current prior authorization role. Thank you for the certification which has led to a strong career where I can work from home while making a decent living. Thank you!

    starstarstarstarstar
    Andrine Toussaint, LPN, PACS

    Andrine Toussaint, LPN, PACS

    Licensed Practical Nurse

    I found the information informative. I knew some of it from doing prior authorizations already but I also learned a lot about different insurance companies and services rather than just medications. I got through it pretty quickly. I liked how the test was laid out with different sections and was easy to follow. The information was easy to understand and follow. I like the links that were throughout the slides for more information. The exam itself was over the material read, no trick questions or hidden information. Overall, I would recommend the course.

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    Taylor Nease

    Taylor Nease

    Prior Authorization Specialist

    I really enjoyed the program as it was pertinent to my current role as a Field Reimbursement Manager at GSK. I heard about the PACS program from our leadership who supported us in obtaining this certification. Overall, it was a great learning experience and well worth the investment!

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    Jay Harding, PACS

    Jay Harding, PACS

    Sr. Director, Market Access

    I think the program was great. Having done this program, I'm trying to make myself more valuable. I want to stand out as someone who's done the program but also for people to reach out to me and ask for help. For me, being a PACS takes my credibility up a couple of notches

    starstarstarstarstar
    Jeni Nelson PACS

    Jeni Nelson PACS

    Territory Manager

    The PACS program was both comprehensive and insightful. The modules were broken down into appropriate segments and together they gave a wonderful view of the entire prior authorization landscape. It was extremely easy to navigate and user-friendly even down to the very responsive chat function!

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    Kristen Hawthorne

    Kristen Hawthorne

    Access and Reimbursement Manager

    Great certification program for the field reimbursement/patient access role. This is beneficial to people in the profession. This gives them an in-depth overview of the operations surrounding reimbursement.

    starstarstarstarstar
    Dorette Shirley

    Dorette Shirley

    Field Reimbursement Manager

    I had a great experience! In terms of the program and design, the content is great. I am already seeing benefits in my role. There are things that I learned in the PACS program that I m using in my conversations with the physicians and nurses. There is tremendous value in the PACS program!

    starstarstarstarstar
    Anil Bulchandani MBA, LSSBB, PACS

    Anil Bulchandani MBA, LSSBB, PACS

    Field Reimbursement Director

    It was a great course. I learned so much!!! Definitely met the needs of my role as a field reimbursement manager. I was excited to learn more about how I could be a better asset and resource to my offices.

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    Lynn Liberati PACS

    Lynn Liberati PACS

    Field Reimbursement Manager

    Prior authorizations are not a multiple choice test that if you put in enough right answers you ll pass and get an approval. The PACS course explained not just the why of the process, but the importance of all the pieces that make up the why. I would recommend this course to anyone involved with the authorization process to better grasp the steps and refresh their skills. I thought I was pretty savvy when it came to prior authorizations but this certification allowed me to further demonstrate my knowledge and skill set.

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    Elizabeth Johnson LPN, CPC, PACS

    Elizabeth Johnson LPN, CPC, PACS

    Patient & Healthcare Advocate

    The PACS Program is designed very well. It helped me sharpen my skills in this area. Overall great course and great learning experiences. There are so many topics that helped me clear my concepts and I will definitely implement that during my routine job.

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    Jayshree Patil

    Jayshree Patil

    Coordinator, Prior Authorization

    I was able to do it as well! It was a very helpful overview. The course allowed me to sharpen my skills and learn new information about areas that are outside of my current responsibilities. I am hoping the certification translates into a bit of an advantage as I continue to interview for market access positions in this highly competitive job market! I also am incredibly grateful for the scholarship provided, I couldn't have signed on without it, so thank you again!

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    Lori Cecutti MBA, PACS

    Lori Cecutti MBA, PACS

    Field Market Access Director

    The PACS course is comprehensive and a well structured training program that reflects real life experiences in the field.

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    JT Hostler PACS

    JT Hostler PACS

    Director of Market Access

    Great certification program for the field reimbursement/patient access role. This is beneficial to people in the profession. This gives them an in-depth overview of the operations surrounding reimbursement.

    starstarstarstarstar
    Dorette Shirley

    Dorette Shirley

    Field Reimbursement Manager

    Prior authorizations are not a multiple choice test that if you put in enough right answers you ll pass and get an approval. The PACS course explained not just the why of the process, but the importance of all the pieces that make up the why. I would recommend this course to anyone involved with the authorization process to better grasp the steps and refresh their skills. I thought I was pretty savvy when it came to prior authorizations but this certification allowed me to further demonstrate my knowledge and skill set.

    starstarstarstarstar
    Elizabeth Johnson LPN, CPC, PACS

    Elizabeth Johnson LPN, CPC, PACS

    Patient & Healthcare Advocate

    I had a great experience! In terms of the program and design, the content is great. I am already seeing benefits in my role. There are things that I learned in the PACS program that I m using in my conversations with the physicians and nurses. There is tremendous value in the PACS program!

    starstarstarstarstar
    Anil Bulchandani MBA, LSSBB, PACS

    Anil Bulchandani MBA, LSSBB, PACS

    Field Reimbursement Director

    What will I learn in the PACS® program?

    1

    The prior authorization process

    Module 1 lays the foundation for understanding the prior authorization landscape. This module goes over what prior authorization is, how it came to be, and who is involved in this utilization management process.
    2

    Insurance policies and pricing

    Module 2 covers insurance policies, payments, and copay assistance. Processing prior authorization requires knowledge of federal, state, and commercial health insurance, drug tiering, formularies, and determining insurance eligibility. To help understand patients who cannot afford prescriptions, there are patient assistance programs and copay programs designed to help patients gain access to necessary medications.
    3

    Compliance - HIPAA, security, fraud and abuse

    Module 3 mitigates risk surrounding compliance standards in the industry by reinforcing law and ethical practice. For reimbursement, it is expected that authorization professionals protect patient information to the standard of HIPAA and ensure accurate coding.
    4

    Medical records and the prescription

    Module 4 explains in detail the components of the medical record and prescription to aid in the authorization process. Valuable information is conveyed in these documents and can help the authorization find information efficiently and successfully.
    5

    Fundamentals before the authorization process

    Module 5 focuses in the value of medical documentation and coding to apply to the prior authorization request. Understanding the ICD-10, CPT, and HCPCS codes as well as medically accepted indications and medical necessity will support the authorization process.
    6

    Communication methods

    Module 6 provides in-depth explanations of the communication methods for the prior authorization process. Effective communication with the payer is imperative for submitting a prior authorization and receiving updated status for the patient.
    7

    Service line and medication process and submission

    Module 7 takes a step-wise approach to the submissions of prior authorization for both medical benefits and prescription benefits. This approach is from the provider perspective to ensure all steps are appropriately taken and the risk of denial is minimized.
    8

    Special considerations for service orders

    Module 8 covers the broad scope of specialties and clinical practice which require authorization. Some services require additional attention, including diagnostic and interventional radiology, oncology, specialty medication, infusion services, J code medications, durable medical equipment, and various therapies. The function is not to memorize the special cases, but to critically think through the workflows.
    9

    Out of network waivers

    Module 9 provides guidance on how to request and achieve an out of network waiver for special cases. This is particularly important for patients who experience limited accessibility and mobility or require particular specialists.
    10

    Coverage determination types in medication

    Module 10 discusses the frequent coverage determinations for medication claims that require additional considerations. This includes quantity limits, tier exceptions, step therapy, step therapy exceptions, and non-formulary exceptions. Considerations are also made for high-risk medications, opioids, Medicare Part B vs Part D, End Stage Renal Disease, hospice, and Drug Utilization Reviews.
    11

    Denials and appeals

    Module 11 describes the denial process and how to overturn the decision with an appeal. Strategic methods exist to review the application for authorization and to appeal with success.
    12

    The future of prior authorizations

    Module 12 presents the future of prior authorizations on a macro level and opportunities in the field as an individual. Prior authorizations continue to expand as the healthcare industry adapts to new challenges.

    Looking to learn as a team?

    GSK
    ABBVIE
    sanofi
    WALGREENS

    Why certify with ACMA?

    Experienced

    10+ years of experience and proven track record in the life sciences industry

    Robust learning management system

    Robust training platform features with on-demand, immersive, and cohort-based learning

    Personalized training

    Personalized learning and actionable learner insights

    Engaging content

    Engaging content using research-driven pedagogical techniques

    Secure

    Secure and reliable next-gen technology

    Support

    24/7 live human chat avaliable

    Explore how PACS® was crafted to transform the industry

    1

    Advisory board

    Several advisory board meetings held with leaders and subject matter experts.

    2

    Accreditation

    ACMA received IACET accreditation, whose processes helped us build a rigorous curriculum.

    3

    Development

    Prior Authorization Certified Specialist program designers developed content using psychometric analysis to ensure that graduates are held to the highest standards of learning and assessment.

    4

    Industry standard

    Prior Authorization Certified Specialist program established standards for knowledge, technical skills and professional practice for those working within the payer landscape.

    5

    Expert insights

    ACMA works with experts from PBMs, payers, pharma, and healthcare to develop the newest and best content for the prior authorization certified specialist curriculum.

    6

    Updated content

    Content is always updated to reflect new business practices, technologies, market challenges and regulatory changes.

    Frequently asked questions (FAQs)

    Is the Prior Authorization Certified Specialist program a certificate or a certification?

    The Prior Authorization Certified Specialist Program (PACS) is an official certification accredited by the International Accreditors for Continuing Education and Training/ American National Standards Institute (IACET/ANSI). ACMA is also a member of the Institute for Credentialing Excellence.

    Who developed the Prior Authorization Certified Specialist program content?

    The Prior Authorization Certified Specialist program (PACS) content was developed by over 30 subject matter experts from academia, managed care, benefit managers, health plans, and experts from the pharmaceutical industry.

    Do I need to maintain my certification?

    Every year you are required to maintain your certification. You can do this by either (1) completing 10 hours of continuing education credits approved by the ACMA or (2) taking the exam.

    How long does the program take to complete?

    The Prior Authorization Certified Specialist program (PACS) takes on average about 10-12 hours to complete. It is self-paced, so everyone will be different. Once you enroll in the PACS program, you have up to 6 months to complete it.

    Do you offer payment options/plans?

    Yes. The ACMA offers a flexible payment plan where you can pay in 3 easy installments. Additionally, you can use PayPal credit if you qualify.

    How do I enroll?

    To enroll / purchase the PACS program please click on one of the 'Enroll Today' buttons. Sign up for an account and proceed to checkout.

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    Become excellent in prior authorization, reimbursement & market access — enroll today