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Prior authorization is supposed to work like a checkpoint. In most practices, it works more like a chokepoint. In the AMA’s 2025 Prior Authorization Physician Survey, 95 percent of [...]

This guide is educational information for medical practices evaluating a medical billing company or revenue cycle management company. It is not legal advice. Have healthcare counsel review any [...]

How Insurer Prior Authorization Requirements Create Revenue Cycle Bottlenecks Prior authorization used to be a staffing decision. Now it’s a revenue decision. The volume of authorization [...]

For most practices, the cost estimate has always been a courtesy. Something you provide if the patient asks for it. A customer service nicety handled somewhere between scheduling and check-in. [...]

Outsourcing medical billing used to be about offloading data entry. In 2026, it is about protecting the revenue you have already earned. Initial claim denials are climbing, payers are deploying [...]

Outsourcing prior authorization used to be a staffing decision. Now, well, it’s a revenue decision. Denials are rising faster than volume, more remote practices are seeing their reimbursements [...]

The vendor pitch sounds clean. The data tells a different story. If you run a practice, a health system, or a specialty group, you’ve probably heard the pitch. An AI vendor says it [...]

Prior authorization isn’t getting simpler. Despite years of reform promises, the 2024 AMA Annual Survey found that physicians now complete an average of 39 prior authorizations per week, [...]

When a claim comes back denied, the instinct is usually the same: send it to billing, figure out what went wrong, and resubmit. That workflow might feel like a system, but for many practices it [...]

I wrote this original post in 2024, and WOW, prior authorizations and their complexities have evolved. In 2025, over 50 major insurers voluntarily pledged to reduce prior authorization [...]