Blog
Prior authorization, denials, and what they cost.
Written for billing managers, practice administrators and RCM leads. Numbers are cited to their source. Nothing here is legal advice.
prior authorization
Most prior authorization denials are never appealed. Here is what that costs a practice.
Most prior authorization denials are never appealed, yet 58 to 65% of appeals win. The leakage math for a five-provider practice and what to track.
prior authorization
Prior authorization decision deadlines in 2026: CMS, commercial, and California workers' comp
Prior authorization clocks for 2026: CMS-0057-F (72 hours / 7 days), ACA and employer plans (72 hours / 15 days), California workers' comp UR (LC 4610).
prior authorization
What the AELP 'Ban Prior Authorization' report means for billing teams right now
AELP and daisyBill argue prior authorization should end. Four things billing teams can act on today, and which side of the table AI belongs on.