Jul 30, 2025 · Payers, Denials & Prior Authorization
From Denials to Approvals: Why the Time to Act on AI in Prior Authorization Is Now
Last week, I had the honor of speaking at the American Rhinologic Society Summer Sinus Symposium in San Diego. What began as a conversation about…
Jul 22, 2025 · Payers, Denials & Prior Authorization
AI, Prior Authorization, and the Hidden Drag on U.S. Device Innovation
July 2025 Executive Summary Across both public and private payers, prior-authorization (PA) denials are increasingly undermining market access for…
May 14, 2025 · Payers, Denials & Prior Authorization
Peering Into Prior Auths: When Surgeons Should—and Shouldn’t—Engage in Peer‑to‑Peer
Deciding when—and when not—to engage in a peer-to-peer review is critical for surgeons navigating today’s increasingly complex prior authorization…
Apr 7, 2025 · Payers, Denials & Prior Authorization
Four Strategies to Improve Prior Authorization Impact On Your Business
UnitedHealth Group Provides Fact Sheet on Medical Claims (10% Denial Rate Reported) Dec. 13, 2024 “UnitedHealth Group today provided the following…
Feb 13, 2025 · Payers, Denials & Prior Authorization
Unique Prior Authorization Notes in Seconds
Discover how Nemedic streamlines your workflow with unique prior authorization notes generated in seconds. Increase efficiency and improve patient…
Dec 8, 2024 · Payers, Denials & Prior Authorization
United Healthcare Denials
Discover how surgeons can prevent UnitedHealthcare claim denials with expert tips and strategies to navigate insurance challenges effectively
Jul 1, 2024 · Payers, Denials & Prior Authorization
Optum Denials for E/M and Stroboscopy
QUESTION I have started to receive a tremendous amount of denials for OPTUM patients that I see and perform a stroboscopy on the same day. The…
Jun 17, 2024 · Payers, Denials & Prior Authorization
Before You Drop Insurance
CAN THERE BE DIRECT PAY “HAPPINESS” WITHOUT THE NEED TO CUT YOURSELF OFF FROM INSURED PATIENTS? As specialists increasingly encounter administrative…
May 8, 2024 · Payers, Denials & Prior Authorization
Combating the Unethical Use of AI to Deny Surgical Prior Authorizations
The Challenge of Automated AI Denials Automated AI denials in surgical prior authorizations have become a pressing issue in healthcare. Initially…
Mar 8, 2024 · Payers, Denials & Prior Authorization
The Ripple Effect of UnitedHealth Group’s Cyberattack
Discover how this healthcare crisis, potentially surpassing COVID's impact, affects surgeons and systems, with over 33,000 payers and 50% of the…
Nov 24, 2023 · Payers, Denials & Prior Authorization
Surgeons on a War Footing
As a healthtech CEO, I’ve been monitoring the intensifying conflict between healthcare providers and payers, a topic recently spotlighted by Brian…
Mar 31, 2023 · Payers, Denials & Prior Authorization
Insurance Companies are Using AI to Block Claims
Explore how Nemedic leverages AI to transform patient care by pre-qualifying individuals for surgery and decreases the burden of documentation,…