A Perfect Storm: Agencies Collaborate on Medical Debt, Price Transparency, Charity Care

Kathryn Beard, JDAugust 17, 2023

Almost 40% of Americans recently reported they were deferring medical care due to the cost of treatment.1 This is particularly true for Americans with low incomes, who have reported cancelling treatment for even the most serious conditions due to an inability to pay for necessary services.


Financial ...

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Why Prior Authorization Reform Should Garner Provider Support

R1 Regulatory TeamApril 14, 2023

In the United States, prior authorization (“PA”) is a cost-containment tool utilized by payers to reduce payment for medically unnecessary or inappropriate patient care. Despite its laudable policy goals, the use of PA faces

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For The Record: Avoid Prior Authorization Denials with Front-End RCM

Connie SmithSeptember 8, 2021

The cost and administrative burden associated with prior authorizations is not new, nor is it getting better for physicians or health systems. According to MGMA, provider practices report a 

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RACMonitor: Medicare Prior Authorization Program - 10 Facts

Dr. Ronald HirschJuly 6, 2020

Today is the first day that prior authorization is required for Medicare beneficiaries to undergo specific surgeries. Here are the 10 things you need to know about the program.

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RACMonitor: Prior Authorization for Medicare Two Weeks Away

Dr. Ronald HirschJune 18, 2020

We are two weeks away from the start of the Medicare prior authorization program, and as of June 17, the Medicare Administrative Contractors (MACs) were required to start accepting requests.

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Becker's Hospital Review: Automation is a Must for Prior Authorization

Alia PaavolaApril 10, 2020

Despite a push by healthcare organizations in recent years to automate the prior authorization process, it is still primarily manual, prolonging the significant financial and administrative burdens absorbed by providers, patients and health plans. 

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