Search a title or topic

Over 20 million podcasts, powered by 

Player FM logo
Artwork

Content provided by Healthcare NOW Radio Podcast Network, Healthcare NOW Radio, Podcast Network - Radio, and Podcasts for the Healthcare Industry. All podcast content including episodes, graphics, and podcast descriptions are uploaded and provided directly by Healthcare NOW Radio Podcast Network, Healthcare NOW Radio, Podcast Network - Radio, and Podcasts for the Healthcare Industry or their podcast platform partner. If you believe someone is using your copyrighted work without your permission, you can follow the process outlined here https://podcastplayer.com/legal.
Player FM - Podcast App
Go offline with the Player FM app!

Revenue Cycle Optimized: From Prior Authorization Chaos to Clear AI Orchestration

29:07
 
Share
 

Manage episode 501353938 series 1758628
Content provided by Healthcare NOW Radio Podcast Network, Healthcare NOW Radio, Podcast Network - Radio, and Podcasts for the Healthcare Industry. All podcast content including episodes, graphics, and podcast descriptions are uploaded and provided directly by Healthcare NOW Radio Podcast Network, Healthcare NOW Radio, Podcast Network - Radio, and Podcasts for the Healthcare Industry or their podcast platform partner. If you believe someone is using your copyrighted work without your permission, you can follow the process outlined here https://podcastplayer.com/legal.
From Prior Authorization Chaos to Clear AI Orchestration Prior authorization isn’t just broken — it’s unsynchronized. On this episode, Evan Martin, VP of Revenue Cycle Management at ZoomCare Inc as well as Host and Producer of The Wilshire’s IT RevCast, shares what happens when real-time care delivery meets a fragmented, rule-heavy prior auth system that can’t keep up. With just one authorization specialist covering 50 clinics, Evan paints a clear picture: today’s healthcare moves fast, but prior auth is still stumbling through a maze of plan-specific rules, outdated workflows, and underperforming automation tools. We explore how even routine imaging, meds, and mental health services become tangled in conflicting payer policies and benefit silos. Evan breaks down the bottlenecks, the firefighting, and the policy blind spots — plus why simply layering automation on top won’t fix it. The real opportunity? An orchestrated model powered by agentic AI triages, retrieves, and routes the right information to the right place — so human teams can actually focus on patient care. This isn’t theory. It’s the lived complexity of treating patients while waiting for permission — and what the future could look like if we finally got the process in tune. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen
  continue reading

4196 episodes

Artwork
iconShare
 
Manage episode 501353938 series 1758628
Content provided by Healthcare NOW Radio Podcast Network, Healthcare NOW Radio, Podcast Network - Radio, and Podcasts for the Healthcare Industry. All podcast content including episodes, graphics, and podcast descriptions are uploaded and provided directly by Healthcare NOW Radio Podcast Network, Healthcare NOW Radio, Podcast Network - Radio, and Podcasts for the Healthcare Industry or their podcast platform partner. If you believe someone is using your copyrighted work without your permission, you can follow the process outlined here https://podcastplayer.com/legal.
From Prior Authorization Chaos to Clear AI Orchestration Prior authorization isn’t just broken — it’s unsynchronized. On this episode, Evan Martin, VP of Revenue Cycle Management at ZoomCare Inc as well as Host and Producer of The Wilshire’s IT RevCast, shares what happens when real-time care delivery meets a fragmented, rule-heavy prior auth system that can’t keep up. With just one authorization specialist covering 50 clinics, Evan paints a clear picture: today’s healthcare moves fast, but prior auth is still stumbling through a maze of plan-specific rules, outdated workflows, and underperforming automation tools. We explore how even routine imaging, meds, and mental health services become tangled in conflicting payer policies and benefit silos. Evan breaks down the bottlenecks, the firefighting, and the policy blind spots — plus why simply layering automation on top won’t fix it. The real opportunity? An orchestrated model powered by agentic AI triages, retrieves, and routes the right information to the right place — so human teams can actually focus on patient care. This isn’t theory. It’s the lived complexity of treating patients while waiting for permission — and what the future could look like if we finally got the process in tune. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen
  continue reading

4196 episodes

Alle afleveringen

×
 
Loading …

Welcome to Player FM!

Player FM is scanning the web for high-quality podcasts for you to enjoy right now. It's the best podcast app and works on Android, iPhone, and the web. Signup to sync subscriptions across devices.

 

Copyright 2025 | Privacy Policy | Terms of Service | | Copyright
Listen to this show while you explore
Play