UNM study: prior authorization, denials and code churn consume clinicians’ time, frustrate rural providers
A small UNM-commissioned study of billing, coding and claims work in New Mexico found clinicians and billers spend substantial time on prior authorization and denials, that frequent coding and formulary changes add extra work, and that rural facilities face steeper access and reimbursement pressures.
The full story
Good morning: Melanie Sontak, a research assistant professor at the University of New Mexico’s Center for Social Policy, presented results from a small qualitative study the center conducted on medical billing, coding and claims in New Mexico. The study, commissioned by the Legislative Council Service and funded with GROW dollars, interviewed 31 health‑care workers (28 in focus groups and three by interview) from a mix of hospitals and smaller clinics across multiple counties.
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