Clinical Operations Improvement

Prior Authorization: How Does It Affect Payers?

2024-02-07T12:41:07-04:00By |Clinical Operations Improvement, Trends|

Prior Authorization is designed to prevent unnecessary expenses. However, the current complexities create challenges for payers, impacting both financial implications and administrative burdens. In this blog post, we will delve into the nuances of prior authorization, exploring its effects on payers and unveiling best practices for a more sustainable and efficient healthcare system.

Enhancing Collaboration in Medical Necessity Criteria

2024-02-07T08:08:12-04:00By |Care Coordination, Clinical Operations Improvement, Healthcare Independent Review, Operational Analysis, Revenue Cycle Improvement, Uncategorized|

Collaboration between healthcare providers and payers is instrumental in navigating the complexities of medical necessity criteria. By fostering a cooperative environment, both parties can work together to ensure that medical decisions align with the best interests of the patient.

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