エピソード

  • Medical Practice Manager Ops Explained main episode for 2026-07-20

    Medical Practice Manager Ops Explained main episode for 2026-07-20
    2026/08/24
    In this episode of Medical Practice Manager Ops Explained, Finch breaks down proven workflows for tackling prior authorization requests that commonly lead to denials and delayed payments. Listeners discover how shifting review processes earlier—by matching patient charts to the latest payer guidelines before submission—prevents most resubmissions and frees staff time. The discussion covers pulling exact policy requirements, copying targeted chart notes with dates and trial details, and logging every denial reason in a shared spreadsheet to spot patterns like missing conservative care proof. Additional tactics include refreshing top payer links weekly, scheduling peer-to-peer calls in dedicated blocks, tracking appeal timelines for expedited handling, and reviewing denial letters line by line for quick corrections such as diagnosis pointers. These steps reduce open claims on aging reports without adding staff hours.

    Key takeaways:
    - Assign upfront chart reviews against current payer rules to align codes and services.
    - Maintain a denial log by payer and code to refine intake forms and training.
    - Use policy checks and precise documentation to minimize vague submissions and follow-ups.

    📩 Have questions or want to share your experience? Reach out at medical@senseofthisshit.com.
    https://www.spreaker.com/podca...
    続きを読む 一部表示
    4 分
  • Medical Practice Manager Ops Explained main episode for 2026-07-13

    Medical Practice Manager Ops Explained main episode for 2026-07-13
    2026/08/17
    In this episode of Medical Practice Manager, Finch breaks down why prior authorization requests stall for days in independent clinics and how simple front-end fixes can slash delays without extra staff. The core issue is often incomplete submissions rather than payer rules, leading to manual reviews, patient wait times, and stalled revenue. Learn to build a quick pre-submission checklist, verify eligibility on the service date, match diagnosis codes precisely, and attach recent progress notes proving medical necessity.

    Key takeaways:
    - Create a shared intake form capturing exact requirements from your top three payers, updated monthly.
    - Track every submission in a spreadsheet to spot patterns like repeated code rejections and refine request letters.
    - Maintain a folder of approved examples for consistent wording.
    - Set daily calendar checks for expiring auths and centralize scattered notes into one document owned by the renewal handler.

    These steps cut repeat requests by half and free hours for denial work. 📩 Have questions or want to share your experience? Reach out at medical@senseofthisshit.com. Support the show: https://www.spreaker.com/podca...
    続きを読む 一部表示
    5 分
  • Navigate Independent Ambulatory Front Desk Prior Auth Denials Playbook

    Navigate Independent Ambulatory Front Desk Prior Auth Denials Playbook
    2026/07/12
    In this episode, we break down a practical front desk-to-denials playbook tailored for independent ambulatory clinic office managers. Discover how rushed intake creates eligibility gaps that trigger prior auth stalls and revenue-draining denials—and how small, routine adjustments can fix the flow before claims ever leave the building.

    Key takeaways include:
    - Implement three quick verification steps during patient check-in to catch coverage mismatches and outdated cards in real time.
    - Submit prior auth requests the same day orders are written, attaching clinical notes and codes via payer portals for faster turnaround.
    - Track auth numbers consistently and review weekly EOB patterns with the team to refine intake questions without adding software or staff.
    - Handle missing auths on arrival by coordinating immediately with ordering offices while patients wait.

    These changes tighten early data collection to build steadier cash flow through existing workflows.

    📩 Have questions or want to share your experience? Reach out at medical@senseofthisshit.com.
    💛 Join Our Supporters Club ($3 a month) 💛 Ad-free listening + early episodes — help keep independent media alive. Click Here: https://www.spreaker.com/podca...
    続きを読む 一部表示
    5 分