Prior Auth, Denials, and Payer Relations: Anthony Grove’s Playbook for Getting Claims Paid

Anthony Grove (VP, Revenue Cycle, LucidHealth) shares practical lessons from decades in healthcare reimbursement, spanning hospital and professional billing. We cover what makes radiology revenue cycle unique (modifiers, technical vs professional components, authorization dependency), how to train teams to write stronger medical-necessity narratives, and how to build an appeal “letter series” that improves overturn rates. Anthony also breaks down how to categorize denials, track appeals over time, and use payer relations to reduce repeat work, plus why payment integrity must include both underpayments and overpayments.

Healthcare in the United States: Helping People Understand the Financial Side of Healthcare: https://www.amazon.com/Healthcare-Uni...