Revenue Cycle Management
What Does a Prior Authorization Company Actually Do?
Prior authorization has become one of the most time-consuming and administratively burdensome processes in healthcare. While insurers use prior authorization to manage utilization and control costs, providers often face growing workloads, delayed care, and increasing operational expenses as they work to obtain approvals for medically necessary services. In fact, the American Medical Association (AMA) reports…
Read MoreUnited Healthcare Prior Authorization Changes Don’t Eliminate Complexity
UnitedHealthcare recently announced plans to reduce prior authorization requirements by another 30%, including many pediatric services and routine outpatient procedures.¹ At first glance, that sounds like a huge win for providers — and honestly, in some ways, it is. Any reduction in administrative work helps. Fewer authorizations mean fewer delays, fewer phone calls, and less…
Read MoreHow to Choose a Prior Authorization Company: 10 Key Factors to Evaluate
Prior authorization remains one of the biggest friction points in healthcare. It slows down patient care, burdens staff, and creates avoidable delays that impact both revenue and outcomes. According to the American Medical Association, over 90% of physicians report that prior authorization delays care, and many say it leads to negative clinical outcomes. At the…
Read MoreTop 10 Prior Authorization Challenges in 2026 (And How Providers Are Solving Them)
Prior authorizations aren’t new, but the pressure surrounding them has never been higher. Between increasing payer requirements, staffing shortages, and rising patient expectations, healthcare organizations are being forced to rethink how they manage authorizations. What used to be a back-office task is now a front-line operational risk impacting revenue, compliance, and patient access. In 2026,…
Read MoreHow to Successfully Outsource Prior Authorizations Without Disrupting Your Revenue Cycle
Prior authorizations have become one of the most time-consuming responsibilities in the healthcare revenue cycle. Between gathering documentation, navigating payer portals, and following up on requests, the process can quickly overwhelm internal staff. For many organizations, outsourcing prior authorizations has become a practical solution. But outsourcing this function requires more than simply handing the work…
Read MoreWhy Prescription Prior Authorizations Continue to Delay Patient Care
Prior authorization has been part of healthcare administration for decades, but in recent years, the burden of prescription prior authorizations has grown significantly. As more specialty medications enter the market and payer policies continue to evolve, providers and pharmacy teams are spending more time navigating approval requirements before patients can begin treatment. For many practices,…
Read More4 Revenue Leaks Costing Rural Hospitals Millions and How to Fix Them
A Practical Revenue Strategy for CFOs Managing Thin Margins and Limited Resources Rural and critical access hospitals often operate with lean revenue cycle teams, leaving little room to absorb staffing vacancies, unexpected backlogs, or sudden increases in payer-related workload. When even one position is vacant or authorization, verification, coding, or A/R volumes increase, work can…
Read More2025 Healthcare RCM Year in Review: Revenue Cycle Trends for 2026
As 2025 comes to an end, the revenue cycle management environment continues to evolve rapidly. Hospitals and physician groups are experiencing increased payer scrutiny, more complex regulatory requirements, and a growing need for stronger front-end and mid-cycle processes. Below is a recap of the most significant trends in 2025 and a look ahead at what…
Read MoreHow Regulatory Reform and Payer Complexity Are Reshaping Revenue Cycle Management in 2025
A Shifting Policy Landscape In 2025, healthcare providers face one of the most turbulent environments in decades. Recent reforms, including sweeping Medicaid funding reductions, capped provider taxes, new eligibility restrictions, and work requirements, are expected to strip coverage from millions of patients over the next decade. Analysts project as much as $1 trillion in Medicaid…
Read More5 Best Practices to Reduce Healthcare Accounts Receivable
Growing accounts receivable is often a symptom of problems that occurred much earlier in the revenue cycle. Missed prior authorizations, inaccurate insurance verification, incomplete clinical documentation, coding errors, and unresolved claim issues can all contribute to delayed or unpaid reimbursement. To reduce healthcare accounts receivable, organizations need to look beyond back-end collection efforts and address…
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