Discussing prior authorization services in oncology practice

Prior Authorization Services: Compliance Walls That Collapse Oncology Billing

Prior Authorization

In oncology, a prior authorization problem can create serious billing issues. A missing clinical note can eventually become a denied claim. An authorization for the wrong treatment phase can become an unpaid drug administration service. An expired authorization can leave an otherwise clean claim sitting in accounts receivable.  For oncology practices, prior authorization services demand…

Oncology prior authorization process showing PET scan and MRI approval delays affecting timely cancer diagnosis and treatment.

Oncology Imaging Delays: Why PET and MRI Get Stuck in Prior Authorization

Oncology Practices, Prior Authorization

PET and MRI are extremely crucial for staging diseases, guiding surgery and radiation planning, detecting recurrence, and accordingly tracking treatment response. But in the US healthcare system, these same scans are among the most heavily scrutinized processes for oncology prior authorization review.  Commercial payers usually ask for extensive documentation for initial procedures like staging, pathology,…