Why healthcare costs what it costs, from someone who has spent 15 years in the front and back office, and what we can actually do about the part I understand.
A correct prior authorization turned into a $150,000 denial, and the bill went to the patient. Six months later she owed nothing. Most people never get there.
Denial prevention has gotten better and all of it should be done. But a clean claim can still be denied, and most organizations are underbuilt for what happens after the denial lands.