Prior Authorization Denials: Playbook for 2026

Most practices treat prior authorization denials like isolated mistakes. That's the wrong frame. The better frame is operational. In 2023, Medicare Advantage plans received more than 50 million prior authorization requests and denied 3.2 million fully or partially, while only 11.7% of denials were appealed, even though 81.7% of appealed denials were later fully or […]

AI in Prescription Refills and Prior Authorizations

Introduction: The Administrative Burden in Healthcare The modern healthcare system, while dedicated to patient well-being, is often characterized by a significant administrative burden. Medical practices, clinics, and hospitals grapple with a deluge of paperwork, phone calls, and intricate processes that divert valuable time and resources away from direct patient care. Among the most time-consuming and […]