Mastering Prior Authorization: A 5-Benchmark Approach
Developing benchmarks for your team is essential to ensure your tasks and projects are progressing as hoped. Here’s an example of how you could set
Understanding and Avoiding Medical Necessity Write-offs
Over the last few years, a major concern for health providers and institutions has been the increasing number of medical necessity write-offs. These are charges
Insurance Gold Card Programs and Government Regulations
Government Regulation and Insurance Gold Card Programs In the realm of public assistance, Government Regulation and Insurance Gold Card Programs play an essential role. These
The Prior Authorization Gold Card Program by United Health Care: A Gimmick?
In recent years, United Health Care (UHC) has introduced a new program called the Prior Authorization (PA) Gold Card. This initiative aims to reduce the administrative
4 Strategies for “Medical Necessity” Denial Prevention
Introduction The goal of every healthcare practice is to keep their patients happy and healthy. However, in order to achieve that goal, it’s important to
Know the Facts – Medical Necessity Denial
When you get a denial letter from your insurance company, it can be overwhelming and stressful. However, knowing the facts about medical necessity denials may
Know the facts – Medical Necessity
Introduction You’ve been in a car accident, and you’re in pain. The doctor recommends physical therapy or surgery to treat your injuries, but your insurance
4 Types of Healthcare System Designs — Pros and Cons of Each
Introduction The healthcare industry is moving towards a new era, where technology and data are driving changes in how health systems operate. Just as the
Medicare 340B Program
Introduction The 340B program is an important part of the Affordable Care Act that requires manufacturers and distributors to provide discounts on medical products to
Need to Know–Top 12 Michigan Regulations for Healthcare Prior Authorization
While recognizing the associated administrative hassles and clinical burdens, here are the top 13 areas that the American Medical Association (AMA) uses to monitor the
Michael Brethorst, MS
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