Karan Kanwar

Who handles prior authorization when your biller is out?

October 22, 2026Oct 22, 2026

The payer's portal wants a six-digit code, and the code is on its way to the biller's phone. She's out until Wednesday. A patient stands at the front desk, waiting to hear whether a prior auth went through. A medical…

The payer’s portal wants a six-digit code, and the code is on its way to the biller’s phone. She’s out until Wednesday.

A patient stands at the front desk, waiting to hear whether a prior auth went through. A medical assistant works down the shared password sheet, two years old by now, until the login locks on the third try. The patient leaves without an answer, and the visit stays unbooked.

At …

Waitlist software fills fewer than half the slots it offers

October 16, 2026Oct 16, 2026

During the vaccine rollout, an opened vial gave a clinic six to twelve hours to use every dose. State and local health authorities told sites to keep standby lists so unused doses could be given before they expired. A canceled…

A canceled appointment carries a deadline of its own, printed in the schedule: the appointment time. The room and the clinician are there for that hour whether or not a patient fills it, …

Nobody owns your EHR templates, and it shows in every note

October 9, 2026Oct 9, 2026

A physician pulls up a patient's medication list mid-visit and stops. Something's off. The patient stopped that drug months ago, and the list never caught up. Nothing in the system flagged it; the physician just happened to notice. Ask who's…

A physician pulls up a patient’s medication list mid-visit and stops. Something’s off. The patient stopped that drug months ago, and the list never caught up. Nothing in the system flagged it; the physician just happened to notice. Ask who’s responsible for making sure that gets caught every time, and nobody has an answer.

Someone built that list years ago, correctly, for a patient who’s since moved on to a different …

After-hours charting isn’t a backlog. It’s a team problem.

September 29, 2026Sep 29, 2026

The last patient leaves around six. Dinner happens, eventually, and the kids go down around eight. The laptop comes back out after that, open to a stack of notes from a day that had exactly zero room in it for…

Two-fifteen was the closest thing to a gap today, and a nurse used it to grab labs. Four-thirty had five minutes, spent walking a worried mother back to the …

Why haven’t ambient AI scribes boosted productivity?

September 17, 2026Sep 17, 2026

A physician finishes today's note noticeably faster than they used to. The AI scribe listened, drafted, and closed most of the gap between seeing the patient and finishing the paperwork. At the end of the day? That's less time hunched…

A physician finishes today’s note noticeably faster than they used to. The AI scribe listened, drafted, and closed most of the gap between seeing the patient and finishing the paperwork. At the end of the day? That’s less time hunched over a keyboard once the last patient leaves.

But ask, three months in, whether the practice is seeing more patients or capturing more revenue because of it. What comes back is …

Patient balance collection is nobody’s actual job

September 2, 2026Sep 2, 2026

A patient is checking out after a routine visit, and the front desk has to say the number out loud: 400 dollars, today, under the deductible. The patient's face changes. The staffer wasn't hired for this conversation and doesn't have…

A patient is checking out after a routine visit, and the front desk has to say the number out loud: 400 dollars, today, under the deductible. The patient’s face changes. The staffer wasn’t hired for this conversation and doesn’t have much beyond “that’s what the system says you owe.”

This exact scene runs in practices everywhere, multiple times a day, and almost nobody standing at that desk was ever specifically trained …

Prior authorization appeals stopped being a decision

August 24, 2026Aug 24, 2026

The letter says denied. It's not the first one this month, and the physician already knows how this goes: Read it, feel briefly annoyed, and move on to the next patient, because the last three appeals went nowhere and there's…

The letter says denied. It’s not the first one this month, and the physician already knows how this goes: Read it, feel briefly annoyed, and move on to the next patient, because the last three appeals went nowhere and there’s no real reason to think this one would be different.

Nothing about that moment is really a decision anymore. It stopped being one a while back, and nobody noticed exactly when.

The …

Closed-loop referral management needs a defined owner

August 18, 2026Aug 18, 2026

A radiologist flags something on a scan that shouldn't be there. The physician sends a referral to oncology that same day, the kind where a few weeks genuinely matter, not the kind you let sit in a queue. The system…

A radiologist flags something on a scan that shouldn’t be there. The physician sends a referral to oncology that same day, the kind where a few weeks genuinely matter, not the kind you let sit in a queue. The system logs it, and the chart shows it as clean and complete: sent.

Four months later, at a visit for something unrelated (a sore shoulder, nothing serious), the physician asks how the …

Triaging patient portal messages is a staffing problem

August 13, 2026Aug 13, 2026

Patients now have a way to reach a physician that no phone call ever offered: directly, in writing, at any hour, with no one screening it first. That was the entire point. It was also, it turns out, the entire…

A patient types “not feeling great today” into the portal. It could mean a cold. It could mean chest tightness they’re downplaying. The message looks the same either way, sitting …

The physician opportunity cost nobody puts on a bill

August 6, 2026Aug 6, 2026

Physicians are precise about the value of their time in exactly one context: when someone else is paying for it. In a contract negotiation that precision is real, the figure gets built from actual numbers, and nobody signs something that…

Then the negotiation ends. The same physician spends Tuesday evening at the kitchen table verifying insurance eligibility for the next morning’s schedule, and the …

Is institutional knowledge loss your staffing problem?

July 30, 2026Jul 30, 2026

The best person at your front desk gives two weeks' notice on a Tuesday. It's nothing dramatic, just a better commute and a job that pays a little more. Everyone wishes her well, and the seat gets filled inside a…

The best person at your front desk gives two weeks’ notice on a Tuesday. It’s nothing dramatic, just a better commute and a job that pays a little more. Everyone wishes her well, and the seat gets filled inside a month.

What doesn’t get filled shows up in pieces over the following weeks. A patient lands in a slot that’s been blocked off for a year, because he gets anxious and …

The biggest risk to your practice is you

July 22, 2026Jul 22, 2026

Ask a physician what the biggest business risk to their practice is, and most will land somewhere familiar. A lawsuit. A bad payer contract. A denial spike that guts a quarter's revenue. It is none of those. For a solo…

Ask a physician what the biggest business risk to their practice is, and most will land somewhere familiar. A lawsuit. A bad payer contract. A denial spike that guts a quarter’s revenue.

It is none of those. For a solo or independent physician, the single biggest risk to the practice is the physician’s own unavailability. Not the clinical kind anyone insures against. The plain fact of not being there to run …

The real reason physicians won’t delegate paperwork