Blog
Strategy, tips, and resources from both sides of the peer-to-peer review call.
Learn exactly how to prepare for a P2P review call with the insurance company's medical director. Includes a framework used by physicians who consistently overturn denials.
Read articleUnderstanding why your prior auth was denied is the first step to overturning it. Here are the 10 most common denial reasons and exactly what to do about each one.
Read articleSpecialty-specific tips for winning peer-to-peer review calls. Covers surgical authorizations, advanced imaging, and procedural denials.
Read articleA comprehensive guide to peer-to-peer reviews in healthcare. What they are, when to request one, what to expect, and how to succeed.
Read articleFree appeal letter templates for prior authorization denials. Includes templates for medical necessity, step therapy, and experimental service denials.
Read articleSpecific strategies for peer-to-peer calls with UnitedHealthcare medical directors. Understand UHC's review process, criteria, and what works.
Read articleA guide for case managers and UM nurses on how to support physicians through the P2P review process. Includes communication templates and workflow tips.
Read articleHow P2P review processes differ between Aetna, Cigna, and Blue Cross Blue Shield. Learn each payer's quirks, criteria sets, and what strategies work best.
Read articleHow small and rural hospitals can manage prior authorization denials and P2P reviews without a dedicated physician advisor or UM department.
Read articleUnderstanding the two major clinical criteria sets used by insurance companies. How InterQual and MCG differ and how to use this knowledge in P2P calls.
Read articlePractical strategies for outpatient practices to reduce prior authorization denials before they happen. Includes workflow changes, documentation tips, and technology solutions.
Read articleHow the prior authorization burden contributes to physician burnout. Data on time spent, emotional toll, and practical solutions to reduce the administrative load.
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