Podcasts about authorizations

In this episode of Thriving Practice, we welcome back Kyle Kiser, co-founder of ArriveHealth, to discuss the company's remarkable growth and its innovative solutions in healthcare technology. Since our last conversation a little over a year ago, ArriveHealth has doubled its revenue, a testament to the value of their real-time benefit network. Kyle shares how their technology is streamlining the prescription process by providing real-time, patient-specific cost information at the point of care. We explore how this system not only helps patients access more affordable medications but also streamlines the often cumbersome prior authorization process, reducing turnaround times from days to hours. Kyle shares insights on how their solution benefits multiple stakeholders in the healthcare ecosystem, from providers and patients to health plans and pharmacy benefit managers. Join us for an enlightening discussion on the future of digital prescribing, medication management, and how technology is being leveraged to enhance trust between patients and providers. Key Points: ArriveHealth's core offering: Real-time benefit network for e-prescribing workflows Company growth: Doubled in size from a revenue perspective in the past year How ArriveHealth's technology works:    - Provides real-time, patient-specific cost information at the point of prescribing    - Suggests lower-cost alternatives for medications and pharmacies    - Streamlines the prior authorization process Benefits for various stakeholders:    - Providers: Reduced administrative burden, improved workflow efficiency    - Patients: Lower medication costs, improved adherence, better healthcare experience    - Pharmacists: Cleaner scripts, fewer callbacks    - Insurance companies/PBMs: Cost savings, reduced administrative work Integration with major EMR systems (Epic, Cerner, Athena, eClinicalWorks) Partnership with GoodRx for additional cost-saving options Success metrics: Switch rates more than twice the industry average Future developments:    - Automating downstream processes (e.g., prior authorizations)    - AI-driven adherence tool for patient-provider communication ArriveHealth's mission: Reintroducing consumer choice in healthcare and leveraging trust between patients and providers Quotes: "We measure success by how often they accept that. And we're seeing switch rates that are more than twice the industry average." - Kyle Kiser on measuring the impact of ArriveHealth's recommendations "The most powerful leverage point to solve problems in healthcare is the trust that exists between patients and providers." - Kyle Kiser on the importance of trust in healthcare Kyle's Bio: Kyle is Chief Executive officer at Arrive Health, the leader in delivering real-time cost and coverage data to decision-making workflows. In his role, he focuses on helping providers and care teams improve patient access, affordability, and outcomes while reducing administrative burden. By partnering with health systems, health plans, IT vendors, and pharmacy benefit managers, Arrive health enables transparency and better patient care nationwide. Since 2013, Klye has helped grow the company from a vision to a reality, and has been at the forefront of some of the most transformational initiatives in healthcare. In particular, he has focused on projects that enable informed decision-making. His focus on interoperability has allowed partners to improve provider workflows and reduce medication costs for millions of patients. Kyle has helped develop incentive strategies for a country's most innovative employers and led product launches with the nation's largest payers. Prior to Arrive Health, he was a senior leader at Welltok, Catapult Health, and Principal Wellness Company.  Find Kyle: Arrive Health Website LinkedIn Connect With Us: Thriving Practice Community Be a Guest on the Show Schedule Strategy Session with Tracy Tracy's LinkedIn Business LinkedIn Page

State Rep. Melanie Stinnett (R-Springfield) serves as the Missouri House Health and Mental Health Committee chair. One of the big issues she's been focusing on in health care is helping doctors with prior authorizations. Chairman Stinnett joined us live on 939 the Eagle's "Wake Up Missouri", telling listeners that testimony shows that Missouri physicians are spending 14 to 15 hours a week just on pre-authorizations. She adds that we then wonder why we can't get in to see a doctor. Chairman Stinnett tells listeners that this is a big challenge for providers and that it's a national issue. She also discussed her "Hope for Missouri Patients Act" during the live interview:

The debate over health insurance denials intensified last year after the assassination of UnitedHealthcare's CEO. In this episode of The Pie, host Tess Vigeland unpacks the economic forces shaping the US healthcare system with economists from the University of Chicago's Harris School of Public Policy. Josh Gottlieb examines the financial burden of insurance denials, Zarek Brot-Goldberg explores how pre-authorizations influence prescription drug choices, and Maggie Shi reveals how hospitals adjust to oversight by reducing wasteful care.

Navaneeth Nair, Chief Product Officer at Infinx, explains how AI-driven automation ensures prior authorization submissions meet payor policy requirements and medical necessity guidelines. By leveraging real-time policy updates and predictive analytics, providers can reduce denials, streamline approvals, and enhance revenue cycle efficiency.

Navigating PT/OT eligibility verification, prior authorizations, and annual re-evaluations presents unique challenges that can disrupt workflows and delay reimbursements. In this episode, Lora Pada, AVP of Client Success, Nishant Kakkar, Associate Director of Operations, and Prachi Sharma, Senior Manager of Operations, share their expertise on overcoming payer-specific hurdles, leveraging automation for efficiency, and implementing best practices to optimize revenue cycle management.

TWITTER/X: @Lone_Candle FACEBOOK: https://www.facebook.com/Lone-Candle-1436129040048603 Author's page: https://www.amazon.com/Dilland-Doe/e/B00TUKIX7S?ref_=dbs_p_ebk_r00_abau_000000 MEDIUM: https://lonecandle.medium.com/medicare-advantage-good-or-bad-part-one-introduction-and-brief-history-aaf9cf45e3e8?sk=8a7e1da0fe695ed7532a802df13dd542 WEBSITE: http://LoneCandle.com/ PATREON: https://www.patreon.com/LoneCandle?fan_landing=true YOUTUBE: https://www.youtube.com/channel/UCK1ebzTqvmZypjliA8ghA6A?view_as=subscriber SOURCES: https://lonecandle.com/?p=16322

In this episode of Revenue Cycle Optimized, Jennifer Glockzin, Senior Manager of Patient Access, demystifies the complex world of medication authorizations. Learn about the two primary types of medication prior authorizations, the role of pharmacy benefit managers (PBMs), and how tools like CoverMyMeds streamline the process.

How South Shore Orthopedics Made Prior Authorizations Easier Recognize the downsides of manual prior authorization processes and how they affect both staff and operations. Explore how greater visibility into data helps South Shore Orthopedics make smarter decisions, spot trends, and keep everything running smoothly. Brought to you by www.infinx.com. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen/

Recognize the downsides of manual prior authorization processes and how they affect both staff and operations. Explore how greater visibility into data helps South Shore Orthopedics make smarter decisions, spot trends, and keep everything running smoothly. Brought to you by www.infinx.com

 September 27, 2024 Ray and Scott welcome guest Marianne Desciose to discuss Prior Authorizations, Pre Certifications, and Eligibility. PRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a QuoteUrology Advanced Coding and Reimbursement Seminars - In-Person SeminarsRegister Now for the Urology Advanced Coding and Reimbursement SeminarClick Here for Information and RegistrationEvent DetailsLocation:Las Vegas: December 6-7, 2024, at HorseshoeNew Orleans: January 31-February 1, 2025, at Harrah'sTime: Friday 8 am - 4 pm, Saturday 8 am - 3:30 pmIncludes: Breakfast and Lunch on both days, plus 14 AAPC CEUs   The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/    Join the discussion:Urology Coding and Reimbursement Group - Join for free and ask your questions, and share your wisdom.Click Here to Start Your Free Trial of AUACodingToday.com

Drs. Sabin Dang and Kat Talcott join to discuss a recent article published by Dr. Dang's team examining the impact of prior authorizations on delivery of treatment in retina practices.Relevant Financial Disclosures: NoneYou can claim CME credits for prior episodes via the AAO website. Visit https://www.aao.org/browse-multimedia?filter=Audi

Navigating the Pitfalls of 'Stat' Authorizations Discover how to classify and submit prior authorization requests to avoid unnecessary delays and ensure timely patient care with Senior Manager for Patient Access, Jennifer Glockzin. Master the strategies for effective communication with insurers and learn to leverage AI tools to enhance the efficiency of your authorization processes. Brought to you by www.infinx.com. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen/

July 22, 2024 - For decades, nonprofit organizations contracting with the state have had to deal with the slow authorization of contracts and delayed payments for services. Megan Allen, CEO of The New York Council of Nonprofits, explains the ramifications of this dynamic and highlights legislation that might speed up this timeline.

Have you ever wondered if marking prior authorizations as "stat" actually speeds up the process? This week, Stuart Newsome, Infinx VP Marketing, sheds light on the intricacies of prior authorization in healthcare and provides you with the knowledge and tools needed to navigate this challenging process more effectively. Brought to you by www.infinx.com

In this episode of "Leaders in Medical Billing," the discussion focuses on the transformative impact of AI and automation within the medical billing industry. Key topics include: AI and Automation Trends in Revenue Cycle Management (RCM): Exploration of current trends in AI and automation. The importance of incorporating automation to stay competitive in the industry. Risks and Liabilities Associated with AI: Analysis of the potential risks and legal liabilities of adopting AI technologies. Guidance on performing due diligence when partnering with technology vendors. Benefits of Automation in Medical Billing: Practical examples of how automation can improve efficiency and revenue collection. Insights into how automation can handle tasks like patient statements and follow-ups, resulting in higher collection rates. Future of AI in RCM: Discussion on the evolving role of AI, including its limitations and potential. Predictions on how AI technologies will shape the future of medical billing and revenue cycle management. Implementation Strategies: Strategies for medical billing companies to integrate AI and automation into their existing workflows. The importance of training staff to work alongside AI technologies to enhance operational efficiency. Legal and Ethical Considerations: Considerations for navigating the legal landscape as AI technologies continue to develop. The importance of maintaining ethical standards while leveraging AI for business growth. This episode provides valuable insights for medical billing companies looking to leverage AI and automation to improve their processes, enhance efficiency, and stay competitive in an evolving industry. For more in-depth discussions and specific takeaways, be sure to listen to the full episode.

Happy 4th of July Week! Please enjoy this Best Of episode. Clark returns July 8th with new ways to Save More, Spend Less and Avoid Getting Ripped Off! Clark offers a primer on the 3 basic types of funds - Mutual, Index, and the fastest growing area of investing: ETFs. Also, there is a new rule for health insurers when you need medical preauthorization approval for treatment or a procedure. And it's about time.  Back To Basics: ETFs: Segment 1 Ask Clark: Segment 2 New Rules On Medical Preauthorization: Segment 3 Ask Clark: Segment 4 Mentioned on the show: How to Invest in ETFs for Beginners  What Is an ETF? Clark.com INVESTOPEDIA - Mutual Funds /  Index Funds /  ETFs Medicare Medical Savings Account (MSA) Plans Health Insurers Must Streamline Prior Authorization Decisions, New Rule Says - The WSJ Businesses Are Making Me Pay the Credit Card Processing Fee. Should I Pay Another Way? Clark.com resources Episode transcripts Community.Clark.com Clark.com daily money newsletter Consumer Action Center Free Helpline: 636-492-5275 Learn more about your ad choices: megaphone.fm/adchoices Public.com+Public Investing Disclosure: All investing involves risk. Brokerage services for US listed securities, options and bonds in a self-directed brokerage account are offered by Public Investing, member FINRA & SIPC. Not investment advice. Public Investing offers a High-Yield Cash Account where funds from this account are automatically deposited into partner banks where they earn interest and are eligible for FDIC insurance; Public Investing is not a bank.Cryptocurrency trading services are offered by Bakkt Crypto Solutions, LLC (NMLS ID 1828849), which is licensed to engage in virtual currency business activity by the NYSDFS. Cryptocurrency is highly speculative, involves a high degree of risk, and has the potential for loss of the entire amount of an investment. Cryptocurrency holdings are not protected by the FDIC or SIPC. . See public.com/#disclosures-main for more information. Learn more about your ad choices. Visit megaphone.fm/adchoices

NTIA is championing Route Origin Authorizations or ROA's as part of the Biden Administration's cybersecurity plan to fend off nation-state hackers and cyberattacks.In tandem with this effort, on June 6, the Federal Communications Commission (FCC) advanced a Notice of Proposed Rulemaking aimed at strengthening internet security through the implementation of border gateway protocols (BGPs) for internet service providers (ISPs). While the National Telecommunications and Information Administration (NTIA) already encourages federal agencies to embrace these routing security protocols, the FCC's proposed rule would mandate broadband providers to submit confidential reports on their BGP usage.This move is an effort to defend against cyber-attacks by validating the legitimacy of websites and securing web traffic, preventing hackers from spoofing government domains, stealing data, and hijacking critical communications.Here to discuss the policy behind this decision, including routing security, BGPs, and efforts to secure government infrastructure, are Grace Abuhamad and Robert (Bob) Cannon. Grace is the chief of staff at the NTIA, where she previously served as a policy analyst in the Office of International Affairs. Bob is a Senior Telecommunications Policy Analyst at the NTIA. Before joining NTIA, he was a Senior Attorney at the FCC's Office of Policy Analysis.

Many new arrivals to western Massachusetts have anxiously waited months for federal work authorizations. Some Haitians living in Greenfield have finally received their documents and are now finding employment at UMass Amherst.

Why Prior Authorizations Are Still Denied After Approval Learn about the surprising reasons why prior authorizations, even when approved, can still be denied. From changes in treatment plans to patient non-compliance, we uncover the complexities behind these common healthcare denials. Brought to you by www.infinx.com. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen/

Learn about the surprising reasons why prior authorizations, even when approved, can still be denied with Stuart Newsome, CPCO, Infinx VP of Marketing. From changes in treatment plans to patient non-compliance, we uncover the complexities behind these common healthcare denials. Brought to you by www.infinx.com

The Senate managed to pass an important bill last week, authorizing the Federal Aviation Administration. That makes the House "it," so to speak. The Senate will move onto some federal bread-and-butter issues, though: Telework and technology procurement. For an update, Federal Drive Host Tom Temin spoke with Bloomberg Government Deputy News Director Loren Duggan. Learn more about your ad choices. Visit megaphone.fm/adchoices

Ever wondered how the U.S. Army Corps of Engineers gets the go-ahead and green light to fund all those vital infrastructure projects across the nation? On this episode of Inside the Castle, we dive into the sometimes-murky world of authorizations and appropriations. We'll break down the key differences between the two terms and explain what it takes for a USACE project to go from the drawing board to reality. So, whether you are a civil engineer, an advocate for your local waterway, or simply curious about how it all works, tune in!

In this episode,  Temara Hajjat and Jenn Lee interview Dr. Matthew Giefer and Dr. Brad Pasternak. Drs. Giefer and Pasternak share their experience advocating for the approval of medications for their patients. The discussion also covers the challenges involved in medication approval, how to approach your local and state representatives, and lobbying in Washington, D.C.Dr. Giefer is a pediatric gastroenterologist at Ochsner Children's in New Orleans, Louisiana, specializing in advanced endoscopy and pancreatology, and Dr. Pasternak is a pediatric gastroenterologist and the Medical Director of the IBD program at Phoenix Children's in Phoenix, Arizona. Learning Objectives:Understand how to advocate for medication approval after they are denied by the insurance. Understand the resources available to tackle prior authorizations and denials. Recognize the importance of advocating and speaking up against insurance denials. Support the showThis episode is eligible for CME credit! Once you have listened to the episode, click this link to claim your credit. Credit is available to NASPGHAN members (if you are not a member, you should probably sign up). And thank you to the NASPGHAN Professional Education Committee for their review!As always, the discussion, views, and recommendations in this podcast are the sole responsibility of the hosts and guests and are subject to change over time with advances in the field.Check out our merch website!Follow us on Twitter, Facebook and Instagram for all the latest news and upcoming episodes.Click here to support the show.

Join us as we unpack what you need to know when it comes to BCBS Federal Prior Authorizations with the CEO of Hear Billing Solutions - Stacey Long! On this webinar, we cover: • Learning the process of BCBS Federal prior authorization requirements...• Reviewing the requirements needed to get the authorization completed...• Getting comfortable with the BCBS Federal authorization process...• Tips and tricks to get the authorization in a timely manner...If you are looking for help with billing for your practice, head over to hearbillingsolutions.com!Don't forget to subscribe to the channel to get alerts on new videos!If you are a hearing practice owner or audiologist, be sure to join our Facebook Group - The Hearing Marketing Mastermind: https://www.audiologyignite.com/groupIf you would like to schedule a free Practice Acceleration Session, head over to https://go.audiologyignite.com/schedule

Dr Millie Long and her IBD Drive Time cohost, Dr Raymond Cross, talk about ways health insurers create barriers to timely treatment for inflammatory bowel disease, particularly through requirements for prior authorization.

The post Find Missing and Expired Authorizations appeared first on Moore Solutions Inc.

After the Jan. 26 announcement from the Biden administration that Department of Energy authorizations for new LNG export projects will be paused for an open-ended period, speculation has swirled about what that could mean for the industry and global supply. Rapidan Energy Group's Alex Munton joins NGI's Jacob Dick to discuss what it means, why it happens and which developing projects might be the most impacted.

Clark offers a primer on the 3 basic types of funds - Mutual, Index, and the fastest growing area of investing: ETFs.  Also, there is a new rule for health insurers when you need medical preauthorization approval for treatment or a procedure.  And it's about time.  Back To Basics: ETFs: Segment 1 Ask Clark: Segment 2 New Rules On Medical Preauthorization: Segment 3 Ask Clark: Segment 4 Mentioned on the show: How to Invest in ETFs for Beginners  What Is an ETF?  Clark.com INVESTOPEDIA - Mutual Funds  /  Index Funds  /  ETFs Medicare Medical Savings Account (MSA) Plans Health Insurers Must Streamline Prior Authorization Decisions, New Rule Says - The WSJ Businesses Are Making Me Pay the Credit Card Processing Fee. Should I Pay Another Way? Clark.com resources Episode transcripts Community.Clark.com Clark.com daily money newsletter Consumer Action Center Free Helpline: 636-492-5275 Learn more about your ad choices: megaphone.fm/adchoices Learn more about your ad choices. Visit megaphone.fm/adchoices

Welcome to The SaaS CFO Podcast, where we explore the intersection of technology, finance, and innovation in the world of software as a service. Today, we have an exciting episode featuring Amber Nigam, the dynamic CEO and co-founder of Basys AI. In this engaging conversation, Amber shares insights into his remarkable journey from a background in computer science and data science to founding BasysAI, a company focused on revolutionizing the healthcare industry. Amber delves into the unique products and services offered by Basys AI, including their innovative use of generative AI to automate prior authorization and utilization management processes for insurance companies. He explains how Basys AI's platform eliminates the need for traditional phone calls and faxes, transforming the efficiency and accuracy of healthcare administration through technology and SaaS solutions. Throughout the episode, Amber provides valuable perspectives on the challenges and opportunities within the healthcare industry, the strategic approach to raising capital in the current macro environment, and the pivotal metrics his team prioritizes for business growth. Join us as we uncover the exciting pilot programs and future initiatives on the horizon for Basys AI, and gain deep insights into the cutting-edge world of healthcare technology from the visionary leader himself. This episode provides a fascinating glimpse into the transformative potential of AI, finance, and technology within the healthcare landscape, and we can't wait for you to hear all about it! Show Notes: 00:00 Basys provides prior authorization and utilization management services using AI and technology, eliminating the need for phone calls and faxes. 03:39 Utilization management regulates healthcare services to control costs. 09:21 Perspective on reaching out to market, involving CMO, CEO, CFO, and other teams for buy-ins. 12:29 Tech companies struggle in healthcare, but investors see potential in startups focused on improving healthcare outcomes. Eli Lilly and Mayo Clinic invest in a patient-centric, transparent platform. 15:29 Healthcare challenges, investor discussions, and selling arguments are key learnings in business. 17:11 Investors vetted product, align tech with healthcare needs for quicker success. 20:44 Exciting start for health plan pilots after funding raise. Links: SaaS Fundraising Stories: https://www.thesaasnews.com/news/basys-ai-raises-2-4-million-in-pre-seed-round Amber Nigam's LinkedIn: https://www.linkedin.com/in/amber-nigam/ Basys.ai's LinkedIn: https://www.linkedin.com/company/basysai/ To know more about Ben check out the links below: Subscribe to Ben's daily metrics newsletter: https://saasmetricsschool.beehiiv.com/subscribe Subscribe to Ben's SaaS newsletter: https://mailchi.mp/df1db6bf8bca/the-saas-cfo-sign-up-landing-page SaaS Metrics courses here: https://www.thesaasacademy.com/ Join Ben's SaaS community here: https://www.thesaasacademy.com/offers/ivNjwYDx/checkout Follow Ben on LinkedIn: https://www.linkedin.com/in/benrmurray

In this episode of Leaders in Medical Billing, our guest Robert Kowalik shares his unique journey from being a physical therapist to transitioning into the billing side. With experience in running a private practice and managing a billing team, Robert saw an opportunity to help other physical therapy practices with their billing needs. He started by focusing on accounts receivable conversion and gradually evolved his approach to a specialty-focused, parallel process billing system. Tune in to learn more about Robert's insights and experiences in the medical billing industry.   Time stamps [00:00:13] Transition from physical therapy [00:07:26] The biggest time inflator. [00:09:41] Variable rate structure for billing. [00:16:38] The black hole concept. [00:17:14] Turning billing into business intelligence. [ 00:23:44] The focus needs to be on the other side of the scale. [00:26:03] Converting billing team to BI team.  

In this podcast episode, hosts Hannah and Michael unveil a series aimed at helping listeners end 2023 on a strong note and kickstart 2024 with momentum. They delve into crucial topics such as optimizing revenue collection and conducting a detailed breakdown of the billing and collections process for home health or hospice agencies. Michael introduces a special offer from HealthRev Partners for agencies looking to recover uncollected funds, emphasizing its importance for financial stability and performance analysis. Interested? Contact connect@healthrevpartners.com for more info. Hannah walks through the steps for entering 2024 with financial peace of mind through HealthRev Partners' Revenue Recovery Agreement. Michael and Hannah share insights on the intricacies of the billing process, stressing the significance of accurate documentation from the patient's referral. They offer practical tips, such as verifying insurance cards and understanding payors. Michael shifts the focus to measures agencies should take regarding their internal teams or partners, including qualifications of coders and reviewers, familiarity with Medicare guidelines, and EHR expertise. Hannah highlights the addition of HealthRev's eligibility and authorizations service, underscoring its role in preventing revenue loss. Michael stresses the importance of getting this aspect of revenue cycle management right and suggests considering outsourcing. The next episode, which will cover the handling of denials and appeals in the healthcare revenue landscape.

Larry Mullins reports

July 21, 2023 Ray and Scott welcome special guest Marianne Desciose, Director of Operations for PRS Managed Services, LLC., to discuss Prior Authorizations and Prior Authorization Denials.Urology Documentation, Coding, and Billing CertificationFor Urologists and APPs (Click Here for Pricing, More Information, and Registration)Documentation, Coding, and Billing Fellowship - Urology (DCB-FS) For Coders, Billers, and Admins (Click Here for Pricing, More Information, and Registration)Documentation, Coding, and Billing Specialist Certification (DCB-SC)Documentation, Coding, and Billing Master Certification (DCB-MC)Urology Advanced Coding and Reimbursement SeminarClick Here to Register Now  Las Vegas, December 1 & 2, 20238 am - 4:30 pm Friday, 8 am - 3:30 pm SaturdayNew Orleans, January 26 & 27, 20248 am - 4:30 pm Friday, 8 am - 3:30 pm SaturdayReserve your spot and save!As a Urology Coding and Reimbursement Podcast listener, you get access to a discount (limited-time offer).Use code: 24UACRS733Get signed up today and get peace of mind knowing you will be prepared for all the upcoming changes.The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ Join the discussion:Urology Coding and Reimbursement Group - Join for free and ask your questions, and share your wisdom.Click Here to Start Your Free Trial of AUACodingToday.com 

Dealing with physical therapy prior authorizations can sometimes feel like a challenging hurdle, potentially affecting the timeliness and quality of care that is provided to patients. We are excited to have Katie Lennon, Strategic Partnership Manager at Raintree Systems, as our guest. With her experience and insights, Katie will guide us through proven strategies to overcome prior authorization challenges, practical tips and the benefit of using integrated system tailored for physical therapy practices. Brought to you by www.infinx.com

In this episode, we talk with Syam Palakurthy, Co-Founder and Chief Executive Officer of SamaCare. Syam shares great insight for streamlining the pre-authorization process to be sure patients don't fall through the cracks. And, he encourages us to lean into process improvement to make a positive impact to patients during a vulnerable time in their life.

In this episode, we are joined by Bevey Miner, EVP of Healthcare IT Strategy & Policy at Consensus Cloud Solutions. She discusses how most payers receive and respond to PA requests today, the main challenge for payers when streamlining authorizations, trends contributing to the healthcare industry's current prior authorization challenges, and much more!This episode is sponsored by Consensus Cloud Solutions.

Pharmacy prior authorizations can be a challenging and time-consuming process. To help navigate this complex landscape, Infinx Senior Director of Client Services, Derek Taylor, PharmD and Infinx Senior Manager of Patience Access, Jennifer Glockzin, explore this today. During this podcast, you'll learn: The key entities involved in pharmacy prior authorizations and their roles The differences between medical and pharmacy prior authorizations The role of the pharmacy and required documentation for success Best practices for optimizing pharmacy prior authorization success Brought to you by www.infinx.com.

Today, Les, Jess, and Jamil discuss the Senate's recent vote to repeal two Authorizations for the Use of Military Force (AUMFs). One, from 1991, authorized the original Persian Gulf War to push Iraq out of Kuwait. The second, from 2002, authorized the 2003 U.S. invasion of Iraq over weapons of mass destruction that were never found.Are either of the 1991 or 2002 AUMFs still necessary? Does this impact the President's ability to act? Does the vote represent a Congressional willingness for U.S. pullback from the Middle East?Hear our experts debate these issues and more in less than 10 minutes on our latest episode of Fault Lines!Want to learn more about this topic? Check out these articles that our experts used to frame our discussion:https://www.cbsnews.com/news/iraq-war-aumf-senate-vote-repeal-authorization-for-use-of-military-force/ https://www.cnn.com/2023/03/29/politics/senate-vote-aumf/index.html Follow our experts on Twitter:@NotTVJessJones@lestermunson@jamil_n_jafferLike what we're doing here? Be sure to rate, review, and subscribe.And don't forget to follow @masonnatsec on Twitter! Hosted on Acast. See acast.com/privacy for more information.

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The bill, which Biden supports, would dismantle the authorizations of military force passed for the 1991 Gulf War and the 2002 Iraq War.

Dr. Peter Marks is the director of the FDA Center for Biologics Evaluation and Research. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. P.W. Marks, H.D. Marston, and L.R. Baden. End of a Declared Public Health Emergency — Implications for U.S. Emergency Use Authorizations. N Engl J Med 2023;388:1153-1155.

Earlier today, the Senate passed a bill repealing military authorizations for the Iraq and Gulf Wars. The bill passed with bipartisan support and a vote of 66-30. But this bill doesn't just formally end these wars overseas. Nan Swift from R Street explains why this is a significant step forward for a Congress seeking to reclaim its constitutional war powers.See omnystudio.com/listener for privacy information.

Joe Biden issues the first veto of his presidency. The House tries to override it, but fails … the House (barely) passes its Parents Bill of Rights, while the Senate considers repealing the Authorizations for the use of Military Force in Iraq … another Bad Biden nominee arrives, while a different one withdraws … former President Trump still not arrested … all this and more.

AMA Vice President of Science, Medicine and Public Health Andrea Garcia, JD, MPH, covers the latest news physicians need to know, including: tracking the Marburg virus disease (MVD) outbreak, Candida auris symptoms, how sleep can impact vaccine effectiveness, and the FDA's latest authorization that certain children six months through four years old are now eligible to receive a single booster dose of Pfizer-BioNTech's updated bivalent shot. American Medical Association CXO Todd Unger hosts.

Senator Tim Kaine (D‑VA) will conclude the event with a keynote address covering the efforts to repeal the 1991 and 2002 Authorizations for the Use of Military Force against Iraq. Hosted on Acast. See acast.com/privacy for more information.

In continuing our observance of American Heart Month, during the next live edition of the Talk Ten Tuesdays live Internet radio broadcast we will zero in on the topic of coding and clinical documentation integrity (CDI) issues related to cardiovascular procedures – and, specifically, the importance of obtaining pre-authorizations for cardiology procedures.Obtaining cardiology procedure pre-authorizations tends to be a time-consuming process, depending on the complexity of the patient's insurance coverage and staff experience. And that is why we invited Susie Vestevech, the COO for TiaTech USA, to walk you through the process, which can range from several days to several weeks, often requiring multiple phone calls and documentation submissions.Every year, some 805,000 people in the United States have a heart attack. Basically, someone has a heart attack every 40 seconds. Making certain that your facility is prepared to obtain cardio procedure pre-authorizations is of vital importance every month, not just in February.The live broadcast will also feature these other segments:Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.SDoH Report: Tiffany Ferguson, a subject-matter expert on the social determinants of health (SDoH), will report on the news that's happening at the intersection of coding and the SDoH.News Desk: Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.

Facts & Spin for February 10, 2023 top stories: US lawmakers try to end 'forever war' authorizations, Zelenskyy addresses an EU summit as fighting rages around Bakhmut, North Korea displays a possible new missile at a military parade, The EU reprimands Twitter for an 'incomplete' content-moderation report, Eight civilians are killed in clashes with UN peacekeepers in the DRC, The Church of England approves same-sex union blessings, Missouri votes not to ban children from carrying guns in public, A survey finds that half of Americans are worse off than they were a year ago, Disney plans to lay off 7,000 workers, and India urges citizens to ‘hug a cow' on Valentine's Day. Sources: https://www.improvethenews.org/   Brief Listener Survey: https://www.improvethenews.org/pod

The "Government-sanctioned extortion" line is mine... it's what I call the for-profit health insurance industry. Think about it. You have to pay them in order to get the prices they've negotiated for medical care of every stripe. If you don't have insurance, you're charged the "list price," but if you pay your monthly extortion to cabal, then the cost for services is what those two entities negotiated.The bottom line is you'll pay, one way or the other.I used to dream of crawling across the line of 65... you know, when I'll be eligible for Medicare. I understood that the current process of insurance companies deciding what treatment you'll get instead of relying on the actual doctor to make those calls wasn't an issue when you were able to get the actual government-supplied Medicare.And it was, until the advent of so-called Medicare *Advantage*.Today, Wendell Potter returns to the show. Potter, still the only health insurance industry employee to turn whistleblower to expose these extortionists for the crooks they are, testified before NYC's Committee on Civil Service and Labor against Mayor Eric Adams' decision to move NY's public worker retirees into an Aetna Medicare Advantage Plan.He opened his testimony by repeating "Medicare Advantage is neither Medicare nor is it an advantage for millions of Americans."Be sure to subscribe to Wendell's newsletter at wendellpotter.substack.comAnd now, after a devastating report from Pro Publica, Potter is turning his sites on the unreasonable and dangerous "prior authorization" requirement that is actually killing patients...And at the end, I'll have a few words to share about the Grammys, which I didn't watch, but now wish I had....

On this episode we did an Ask us Anything event. We got into some great topics like; HIPAA Compliance, Authorizations, CAQH, and so much more!

Taking care of legal matters before a crisis helps ensure that you, not lawyers or courts, remain in control – it may even save countless disagreements further down the line. Make sure these essential legal documents don't cause wrinkles in your plans by tuning into This Is Getting Old: Moving Towards An Age-Friendly World and my guest this week, Cameron Huddleston. Key points covered in this episode: ✔️Estate Planning, Advance Care, and End-of-Life Planning—It's  Not Just Something For The Rich When people hear the term estate planning or end-of-life planning, legal documents, people often think, well, this is something that rich people do. I don't need to worry about an estate plan because I don't have an estate. An estate is really just a fancy word of saying your property, your belongings, and your assets. If you die without a will, state law will determine who gets your assets. That means your things might go to someone you don't want to receive those things, or it also might mean that your property needs to be divided up – and it may not be divided in the way you wanted it to be.  ✔️ Understanding Power of Attorney  You want to get the Power of Attorney (POA) document right because this gives someone permission to manage your finances. You want to make sure you're giving them the right permissions. You want to have an attorney sit down and discuss what powers you want to give that person and make sure it complies with your state law. There are different types of power of attorney—you can have general or limited durable or springing power of attorney.  General or Limited Durable POA General or Limited Durable POA might be, for example, you're going out of the country, and you need someone to sign some real estate papers for you so you can designate someone as your limited power of attorney who can only sign documents related to real estate for you,  Springing POA Springing means that power of attorney will spring into effect when certain conditions are met. Typically people will say this will spring into effect if I am deemed mentally incompetent through a diagnosis of dementia or stroke.  But most estate planning attorneys and other law attorneys will discourage people from getting that springing power of attorney because it makes it much more difficult for that person you named as your agent to step in and help you. ✔️When and How to Access the Documents Copy for Medical Record Medical documents, including your Health Care Power of Attorney, your Living Will, and Advance Directives (including a Do Not Resuscitate document, if you have one) should be shared with all of your medical providers. You want your providers to have copies of those documents in your . medical chartThey're going to put it in your patient portal online so that if you are in the hospital and you don't want to be resuscitated, there is that documentation there that they can refer to and say, this patient doesn't want to be resuscitated, this patient doesn't want to be on life support, this patient has named their child as their health care proxy.  Original Copy for Executor (may need to be notarized) Giving the executor of your estate an original copy of your will is also a good idea.  Financial institutions will accept copies, but typically they want it to be a notarized copy. Or you could take the original to the bank. They will make a copy of it and keep it in the files. But if you're even if you trust your power of attorney 100%, you're still feeling a little anxious about handing over that power. Hang onto the document yourself and put it someplace safe in a home safe.  Remove all documents from the home if an outside caregiver comes into the home A word of caution here to family caregivers—if you're caring for an aging parent and you're putting outside caregivers in that home with that person, you need to be aware that you need to remove all financial paperwork so that fraud or elder financial abuse doesn't happen. ✔️ Authorizations When it comes to government agencies, a POA is not enough. Several of them have their own paperwork that has to be filled out.  Medicare Representative Designee/ POA If you are caring for an aging parent and have to help manage their Medicare benefit, to get on the phone and talk to someone within the Medicare agency, you're going to have to be designated as your parent's Medicare representative. Go online and get the form, and if you have already been named power of attorney, then you can fill out that form and sign it as your parent's power of attorney. Social Security Administration  If you have to manage a parent's Social Security benefits, you must be designated as your parent's Social Security representative payee. This would be best to go to your local Social Security Administration office and sit down with someone there and go through the process of filling out the paperwork, showing that power of attorney document. Other responsibilities come with that, so you have to file an annual report with the Social Security Administration detailing how you manage your parent's benefits and how you spent those benefits for your parent. Internal Revenue Service (IRS) to sign tax returns IRS has a form you must fill out to be designated as your parent's agent. You need to read the instructions carefully, and you will also submit that power of attorney document when you send in the tax return and the additional IRS form.  Name a Trusted Contact with financial institutions It's also good to name a trusted contact with your financial institutions. Some will ask for it, and some won't. Still, you can go ahead and say, “Hey, can I name a trusted contact? This is someone your financial institution can reach out to if you can't reach me or if it suspects that financial exploitation is going on.” It's just another way to protect yourself financially.  If you have questions, comments, or need help, please feel free to drop a one-minute audio or video clip and email it to me at melissabphd@gmail.com, and I will get back to you by recording an answer to your question.  About Melissa Batchelor, PhD, RN, FNP, FGSA, FAAN: I earned my Bachelor of Science in Nursing ('96) and Master of Science in Nursing ('00) as a Family Nurse Practitioner (FNP) from the University of North Carolina Wilmington (UNCW) School of Nursing (SON). I genuinely enjoy working with the complex medical needs of older adults. I worked full-time for five years as FNP in geriatric primary care across many long-term care settings (skilled nursing homes, assisted living, home, and office visits), then transitioned into academic nursing in 2005, joining the faculty at UNCW SON as a lecturer. I obtained my PhD in Nursing and a post-master's Certificate in Nursing Education from the Medical University of South Carolina College of Nursing ('11). I then joined the faculty at Duke University School of Nursing as an Assistant Professor. My family moved to northern Virginia in 2015 which led to me joining the George Washington University (GW) School of Nursing faculty in 2018 as a (tenured) Associate Professor. I am also the Director of the GW Center for Aging, Health, and Humanities. Please find out more about her work at https://melissabphd.com/.