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Insurance companies vow to fix prior authorization process…again

Medical Economics

Key initiatives include standardizing electronic submissions, reducing claims subject to prior authorization, and ensuring continuity of care during insurance transitions. This action is designed to help patients avoid delays and maintain continuity of care during insurance transitions. Beginning Jan. Expanding Real-Time Responses.

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5 Risk Control Considerations as Nurse Practitioners’ Scope of Practice Expands

Minority Nurse

If a patient suffers adverse outcomes and lacks documented informed consent, NPs could face liability claims for failing to provide adequate information. Therefore, establishing clear communication and maintaining thorough documentation is essential. Documentation. Malpractice Insurance.

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Low-income patients face uphill battle when fighting health insurance denials, Umass research finds

Medical Economics

adults with private health insurance between 2017 and 2019. Another finding: about 40% of all denials were due to billing errors by health care providers or processing mistakes by insurers—a reminder that many denials are not based on medical necessity or policy rules, but administrative mishaps.

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How to Embrace AI as Your Clinical Assistant

Valant

Many therapists use AI transcription services during sessions instead of documenting sessions by hand. Clinical documentation is a particularly important application of AI technology because documentation so often contributes to provider burnout. Improved work-life balance. More comprehensive notes.

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The Unexpected Burden of Billing for Small Behavioral Health Practices

Valant

Behavioral health providers managing both clinical care and business operations face unique challenges: complex prior authorization requirements, extensive documentation standards, and insurance coverage barriers. Insurers denied 19% of in-network claims in 2023 , according to the Kaiser Family Foundation.

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Ep. 68: Hidden risks of prescribing GLP-1 drugs with Ericka L. Adler, J.D., of Roetzel & Andress

Physicians Practice

Off-Label Use Legal Concerns (00:02:49)** Explains legal concerns with off-label prescribing and how to mitigate risks through documentation and informed consent. Insurance Denials and Prior Authorizations (00:11:26)** Challenges with insurance coverage, prior authorizations, and evolving insurer policies for GLP-1 prescriptions.

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Finding Your Community: The Best of r/therapists for Behavioral Health Providers

Valant

r/therapists offers advice on practice management, such as detailed discussions on handling insurance claims. Professionals on r/therapists share links to articles, studies, and news about mental health, therapy techniques, and new research. Members sometimes share anonymized cases to seek advice or discuss treatment options.