Prior Authorization

Prior Authorization expansion on the move

Prior Authorization continues to be a significant barrier for patients and providers. It has caused greater financial waste for providers and increased delays for patients.   According to the AHA survey, one 17-hospital system reported spending $11 million annually just to comply with health plan prior authorization requirements.  Efforts to streamline and standardize have failed …

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Radiation Oncology Audit Insights

Are you struggling with your Evaluation and Management reimbursement for Radiation Oncology services? Radiation Oncology has nuances, and you may be leaving money on the table without a good understanding of how the 2021 Evaluation and Management guidelines impact Oncology services.

When capturing Evaluation and Management services, the goal is to capture the true data behind the risk and problems addressed to report the service accurately. Beyond the reimbursement, what else does the accuracy of code capture do?

The Prior Authorization Barriers in Orthopedics

It’s a fact that in the current healthcare landscape that the amount of Prior Authorization errors or lack thereof are draining the healthcare industry in finance and resources. When a patient needs a service, and a facility is overrun with orders it can be a very complicated task for a clinic or facility to manage with so many …

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