Blog

In Part 6 of The Prior Auth Reckoning series, Dr. Steve Kim unpacks why clinical documentation remains one of healthcare’s biggest guessing games. With proprietary payer criteria, fragmented EHR workflows, and limited staff training, providers face constant uncertainty about what evidence payers will accept. Learn how technology, data mapping, and decision support can replace trial-and-error with precision and confidence.

In Part 5 of The Prior Auth Reckoning series, Dr. Steve Kim exposes one of the most overlooked sources of denials in healthcare: provider and facility matching. Even the smallest NPI or TIN mismatch can invalidate an authorization and cause major financial fallout. Learn why precision is key—and how automation can prevent costly errors before they reach the payer.

Prior authorization submissions should be simple—but fragmentation has made them one of healthcare’s biggest operational burdens. In Part 4 of The Prior Auth Reckoning series, Dr. Steve Kim explores why managing 900+ payer portals has become unsustainable, how contractual complexity compounds errors, and what providers can do now to consolidate workflows, reduce denials, and protect patient access.

Before prior auth even begins, staff face a costly mystery: does a service require authorization? In Part 3, Dr. Steve Kim breaks down the delegation maze, false negatives, and the hidden costs of payer fragmentation—plus what providers can do to get ahead.

Despite billions invested in EHRs, most prior authorization work still happens outside the system through manual workarounds. In Part 2 of our series, Valer CEO Dr. Steve Kim explores why EHRs fall short, the limits of DaVinci FHIR, and how providers can move beyond fragmented, inefficient workflows.

Prior authorization isn’t just a regulatory or technology issue—it’s a workforce one. In Part 1 of our series, we explore the hidden staffing gaps that slow submissions, create inefficiencies, and undermine patient access teams—and how providers can start closing them.

Our Prior Auth Impact Meter tracks the real-world impact of new policies, technology, and other proposed solutions for prior auth.