Mastering the Complexities of Healthcare Authorization and Denial Prevention

Hospitals and health systems face significant challenges in securing insurance authorizations and preventing denials. These obstacles impact cash flow, disrupt workflows, and, most importantly, delay patient care.

With prior authorization issues being one of the top causes of claim denials, a proactive, structured approach is essential.

Heather Nickerson, Senior Revenue Cycle Account Manager, and Daniel Douglas, Vice President of Operations at Coronis Health break down the complexities of healthcare authorization and denial prevention, highlighting how communication, education, centralized workflows, and technology can reduce denials and improve operational efficiency. They share real-world success stories and actionable strategies to help providers navigate these challenges effectively.

Key Takeaways:

• Streamline communication and workflows to improve efficiency and reduce errors.
• Use centralized processes and technology for better authorization management.
• Blend automation with human expertise to handle complex payer requirements.