Signals from
the frontline.
Short reads on oncology prior auth, payer behavior & practice operations, grounded in published research, customer discovery & the realities of community care.
The average PA is hiding the problem
Averages can look manageable while a small set of authorizations stretches for days or weeks. Here’s why the long tail matters more than one headline number.
There is no single “oncology denial rate”
Published oncology denial rates vary by setting, workflow & denominator. Here’s how to benchmark your practice without comparing apples to infusion pumps.
When a denial becomes a physician task
Peer-to-peers can consume clinical time even when denials are ultimately overturned. The better question is what should have been ready before the call.
Your payer mix is a workflow variable
Turnaround, documentation rules & escalation paths vary by payer & plan. Treating them as one workflow makes the dashboard cleaner, not the work easier.
Approval is not the same as access
A treatment can eventually be approved & still lose days along the way. What 209 patient-days of delay across three community oncology practices can teach us.
What should AI actually do in prior auth?
Automate the repetitive parts. Surface missing evidence. Keep humans in control where clinical judgment, documentation & payer-facing decisions matter.
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