The business of American medicine, explained by someone who practices it.
I am a PA-C. I write plain-language analysis of the money, rules, and paperwork standing between patients and their care, for the clinicians, administrators, and billing teams who keep medicine running.
The Latest
What is changing right now, and what to do about itMedicare Is Now Using Artificial Intelligence to Review Prior Authorizations. Here Is What Providers Need to Know.
In six states, private technology companies now review Medicare prior authorizations using artificial intelligence, and they earn a share of every dollar of denied care. The full breakdown: the 15 services, the vendors, the lawsuit, and the playbook for providers.
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The prior authorization files, practice finance, and provider policyThe 2026 Medicare Fee Schedule Gave a Raise on Paper. Many Will Still See a Cut.
The conversion factor went up, but an efficiency adjustment and a facility cut quietly offset it. Who actually gains and who loses in 2026.
MedicareMedicare Telehealth Survived the 2026 Cliff. Here Is Where Things Stand.
The flexibilities lapsed, then got a two-year reprieve through 2027. What is covered now, what is permanent, and the new deadline to watch.
Prior AuthorizationOnly About 3 Percent of Texas Providers Earned a Gold Card
Five states let high-performing providers skip prior authorization entirely. Almost nobody qualifies. The playbook for joining the few who do.
Prior AuthorizationNew Federal Prior Authorization Rules Took Effect in January
Insurers now face 72-hour deadlines and must explain every denial. What the new federal rules actually change for your practice, and what they leave untouched.
Prior AuthorizationThe Peer-to-Peer Review Is a Game Nobody Teaches You
Word-for-word scripts and tactics for the ten-minute phone call that decides whether your patient's care gets approved.
Prior AuthorizationYour Prior Authorization Was Denied. The Next 72 Hours Decide Whether It Stays That Way.
Most denials are never appealed. Most appeals win. The hour-by-hour playbook, the appeal letter skeleton, and the external review step almost nobody uses.
Provider RightsWhen Providers Speak Out, Who Has Their Back?
Clinicians who challenge insurers publicly often pay for it. Inside the Healthcare Professional Speak FREE Act and the push for real whistleblower protections.
Practice FinanceRunning an Independent Practice Has Never Been Harder
Closures keep climbing, margins keep shrinking, and yet some clinics are figuring it out anyway. What the survivors are doing differently.