Prior authorization for surgical procedures continues to be one of the most frustrating and costly hurdles in the revenue cycle. In this episode of Office Hours, Bo Bowman and Stuart Newsome unpack the hidden hazards that routinely derail authorizations—before a procedure is even scheduled.

Drawing on firsthand experience and fresh examples from real-world surgical workflows, they explore the most common pitfalls, including failure to prove medical necessity, inaccurate procedural coding, insufficient documentation, and timing missteps. They also touch on the role automation and AI can play in supporting human teams—helping to surface missing requirements, flag coding mismatches, and push authorizations forward before deadlines hit.

Whether you’re on the clinical side, in operations, or supporting from RCM or technology, this session will give you a clearer path forward and arm you with the awareness needed to avoid denials, delays, and administrative fatigue.


Learning Objectives

  1. Understand the top reasons surgical prior authorizations are denied—including documentation gaps, failure to establish medical necessity, and inaccurate CPT or ICD code pairings.
  2. Recognize early warning signs in the workflow that increase the likelihood of denials, especially when authorizations are pursued too close to the scheduled procedure date.
  3. Identify how automation tools can support—but not replace—human workflows by helping flag common issues early and improve coordination across clinical, billing, and authorization teams.

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