Breaking Health Episode: 172 - Solving Prior Authorization from Both Sides with Jeremy Friese
9 snips
May 13, 2025 Jeremy Friese, CEO of Humata Health and former interventional radiologist, dives into the challenges of prior authorization in healthcare. He discusses innovative solutions to streamline this process using technology and AI. Friese reflects on his journey from physician to entrepreneur, sharing insights on founding startups versus scaling businesses. The conversation also touches on the evolving relationship between providers and payers, the importance of team dynamics, and the need for fundraising and support for women in healthcare entrepreneurship.
AI Snips
Chapters
Transcript
Episode notes
Prior Auth Will Stay — Make It Better
- Prior authorization won't disappear because it helps control costs and prevents unnecessary care.
- The realistic goal is to streamline, automate, and make prior auth transparent to protect patients and outcomes.
Design For All Specialties And All Payers
- Build a prior auth solution that handles every specialty, every payer, and the full end‑to‑end workflow.
- Prioritize universal coverage, long‑tail payer support, and end‑to‑end automation.
Gold‑Carding Needs To Be Intelligent
- Gold‑carding can add complexity because it fragments rules across CPTs, payers, and sites.
- The better approach is 'intelligent gold carding' embedded into clinician workflows and rev cycle systems.