NatRevMD

#195 The GLP-1 Bridge Just Broke Your Prior Auth Workflow


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WE ARE RE-AIRING THIS EPISODE BECAUSE IT MATTERS RIGHT NOW. 

On July 1, 2026, the Medicare GLP-1 Bridge went live. Every independent practice with Medicare patients on Wegovy, Zepbound KwikPen, or Foundayo for weight management is now facing retrospective prior authorizations routed through a central processor most billing teams have never worked with. 

The AMA released physician guidance on June 26. The workflow is new. The documentation burden is heavier than most practices have modeled. And prior auth was already the fastest-growing revenue threat independent practices face. 


In this episode Dr. Heather walks through: 

WHAT WE COVER 

  • Why prior auth denials are silently eating clinical time and revenue 
  • The dollar amount your practice is losing every month (and how to calculate it) 
  • The 5-step workflow to manage prior auth without drowning your team What every practice needs to change this week 

"Prior auth has a dollar amount attached to it. Most practices never calculate it." 

THREE ACTIONS THIS WEEK 

1. Calculate what prior auth is costing your practice in staff hours, denied claims, and clinical time 

2. Set up a central prior auth tracker (do not run this out of email threads) 

3. Train the team on the Medicare GLP-1 Bridge central processor workflow before the backlog compounds

...more
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