The 4pm Friday denial: why MSK prior auth fails when it matters most
A look at the prior-auth submission patterns that get rejected disproportionately on Friday afternoons, and the payer-specific workarounds that catch them.
Field notes from the operating room, the front desk, and the CFO's spreadsheet. Written for the people running MSK practices and the operators thinking about acquiring them.
Read in order. Why horizontal AI loses MSK, what MSK-native actually requires, and the case for one stack vs nine point tools.
A look at the prior-auth submission patterns that get rejected disproportionately on Friday afternoons, and the payer-specific workarounds that catch them.
Practice administrators spend 12+ hours a week stitching point tools together. Here's what that looks like priced as opportunity cost.
Generic prior-auth automation treats every CPT code the same. MSK doesn't work that way. The procedure-specific patterns that catch the denials.
Heroic selling works until it doesn't. The signals that tell you it's time to make the founder credibility transferable.
Aligned incentives between device reps and MSK practice throughput. How the channel actually works and what makes it defensible.
A field map of triage, capture, scheduling, prior auth, care management, and revenue cycle, with the leak rates we've seen at each step.
We'll walk your patient episode with you. You'll see exactly where the revenue is walking out.