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Medical Practice Manager Ops Explained is a medical practice manager podcast for independent clinic office managers—front desk to prior auth to denials playbooks. We own front-desk SOPs, prior-auth workflows, denial...
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Medical Practice Manager Ops Explained is a medical practice manager podcast for independent clinic office managers—front desk to prior auth to denials playbooks. We own front-desk SOPs, prior-auth workflows, denial triage, and independent ambulatory ops for office managers. Practical medical practice manager operations—not MSO enterprise theatre. Search Medical Practice Manager Ops Explained on Spotify and Apple Podcasts for weekly prior auth, denials, and clinic office manager episodes. Audio for this show is produced with AI assistance. Episodes are researched, scripted, and reviewed for accuracy before release.
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24 AUG 2026 · In this episode of Medical Practice Manager Ops Explained, Finch breaks down proven workflows for tackling prior authorization requests that commonly lead to denials and delayed payments. Listeners discover how shifting review processes earlier—by matching patient charts to the latest payer guidelines before submission—prevents most resubmissions and frees staff time. The discussion covers pulling exact policy requirements, copying targeted chart notes with dates and trial details, and logging every denial reason in a shared spreadsheet to spot patterns like missing conservative care proof. Additional tactics include refreshing top payer links weekly, scheduling peer-to-peer calls in dedicated blocks, tracking appeal timelines for expedited handling, and reviewing denial letters line by line for quick corrections such as diagnosis pointers. These steps reduce open claims on aging reports without adding staff hours.
Key takeaways:
- Assign upfront chart reviews against current payer rules to align codes and services.
- Maintain a denial log by payer and code to refine intake forms and training.
- Use policy checks and precise documentation to minimize vague submissions and follow-ups.
📩 Have questions or want to share your experience? Reach out at medical@senseofthisshit.com.
https://www.spreaker.com/podcast/medical-practice-manager-ops-explained--7172812/support
Transcribed
17 AUG 2026 · In this episode of Medical Practice Manager, Finch breaks down why prior authorization requests stall for days in independent clinics and how simple front-end fixes can slash delays without extra staff. The core issue is often incomplete submissions rather than payer rules, leading to manual reviews, patient wait times, and stalled revenue. Learn to build a quick pre-submission checklist, verify eligibility on the service date, match diagnosis codes precisely, and attach recent progress notes proving medical necessity.
Key takeaways:
- Create a shared intake form capturing exact requirements from your top three payers, updated monthly.
- Track every submission in a spreadsheet to spot patterns like repeated code rejections and refine request letters.
- Maintain a folder of approved examples for consistent wording.
- Set daily calendar checks for expiring auths and centralize scattered notes into one document owned by the renewal handler.
These steps cut repeat requests by half and free hours for denial work. 📩 Have questions or want to share your experience? Reach out at medical@senseofthisshit.com. Support the show: https://www.spreaker.com/podcast/medical-practice-manager-ops-explained--7172812/support
Transcribed
12 JUL 2026 · In this episode, we break down a practical front desk-to-denials playbook tailored for independent ambulatory clinic office managers. Discover how rushed intake creates eligibility gaps that trigger prior auth stalls and revenue-draining denials—and how small, routine adjustments can fix the flow before claims ever leave the building.
Key takeaways include:
- Implement three quick verification steps during patient check-in to catch coverage mismatches and outdated cards in real time.
- Submit prior auth requests the same day orders are written, attaching clinical notes and codes via payer portals for faster turnaround.
- Track auth numbers consistently and review weekly EOB patterns with the team to refine intake questions without adding software or staff.
- Handle missing auths on arrival by coordinating immediately with ordering offices while patients wait.
These changes tighten early data collection to build steadier cash flow through existing workflows.
📩 Have questions or want to share your experience? Reach out at medical@senseofthisshit.com.
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Medical Practice Manager Ops Explained is a medical practice manager podcast for independent clinic office managers—front desk to prior auth to denials playbooks. We own front-desk SOPs, prior-auth workflows, denial...
show more
Medical Practice Manager Ops Explained is a medical practice manager podcast for independent clinic office managers—front desk to prior auth to denials playbooks. We own front-desk SOPs, prior-auth workflows, denial triage, and independent ambulatory ops for office managers. Practical medical practice manager operations—not MSO enterprise theatre. Search Medical Practice Manager Ops Explained on Spotify and Apple Podcasts for weekly prior auth, denials, and clinic office manager episodes. Audio for this show is produced with AI assistance. Episodes are researched, scripted, and reviewed for accuracy before release.
show less
Information
| Author | Let's Work This Sh*t Out |
| Organization | Let's Work This Sh*t Out |
| Categories | Business , Society & Culture |
| Website | www.senseofthisshit.com |
| medical@senseofthisshit.com |
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