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...
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Charlene Wang
Anthony C. Grove is the Vice President of Revenue Cycle at LucidHealth, a national leader in physician-led radiology management. He is a seasoned healthcare finance professional with over 15 years of experience in optimizing revenue cycle performance and payor relations.
