Monitor Mondays

Out of Town by Sundown: “Must Be Done by End of Business Day.” Payer-Provider Pressure


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Are you experiencing an increase in calls from payers giving you two to three hours to send clinical documentation required to obtain an authorization, or else your claim will be denied? 

Are you being told you cannot have a peer-to-peer session because your request was considered late? 

Are you hearing that you must have everything — “pre-denial” or “pre-auth” — done within 72 hours of notification, only they typically wait until they only have three hours left? 

During this edition of Monitor Mondays, listen and learn what Val Kraus and his team at one major Midwest health system are doing to reduce the impact of these scenarios.

The broadcast rundown also will include:

  • Monday Focus: RACmonitor investigative reporter and New York attorney Edward Roche reports on what he says is the death of statistical extrapolation of Medicare audits by way of qui tam demands.

  • Opioid Crisis: The Purdue Lawsuit: Nationally renowned whistleblower attorney Mary Inman, featured in The New Yorker, returns to the broadcast to report on the major opioid lawsuit involving Purdue Pharma. The lawsuit is part of a national effort to force pharmaceutical companies to pay, in part, for the damage inflicted as a result of opioid healthcare crisis.

  • Risky Business: Healthcare attorney David Glaser returns to Monitor Mondays with his popular segment, in which he reports on Medicare Advantage and other problematic issues facing providers.

  • Hot Topics: Monitor Mondays senior correspondent Nancy Beckley, president and CEO of Nancy Beckley and Associates, returns to report on all the latest hot topics.

  • Monday Rounds: Ronald Hirsch, MD, vice president of R1 Physician Advisory Services,  makes his Monday Rounds with another installment of his popular segment.

Register now for this important news broadcast coming up at 10 a.m. EST on the first Monday of the month, Feb. 4, 2019. 

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