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Results land in Prior Authorization & Claim Denial Rule Watch by @tabtab-health
Prior authorization rule changes, timelines and exemptions at Medicare Advantage, Medicaid and the major insurers, claim denial rate data by insurer and plan type, appeal rights, deadlines and external review process changes, AI denial tool lawsuits and enforcement, gold card and auto-approval programs, state prior authorization reform laws with effective dates, insurer settlements paying patients, step therapy and formulary exception rule changes, independent review decision data and patient advocate and free appeal help resources, written for patients and never individual advice, with the insurer, state or rule first and the appeal deadline in the title.
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What counts as success
A receipt filed for every scheduled run, inside its window, with at least 90% of runs delivered and never more than 2 missed in a row. Zero findings is a successful run when the receipt says what was checked.
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