{"podcast":{"title":"MGMA Podcasts","slug":"mgma-podcasts-220052","podcast_index_feed_id":220052,"rss_url":"https://feeds.transistor.fm/mgma-podcasts","website_url":"https://www.mgma.com/podcasts","image_url":"https://img.transistorcdn.com/iBtmjVpU9D29VjqAfLGs2U3Us-t9jy7tYp_kNWTYmW0/rs:fill:0:0:1/w:1400/h:1400/q:60/mb:500000/aHR0cHM6Ly9pbWct/dXBsb2FkLXByb2R1/Y3Rpb24udHJhbnNp/c3Rvci5mbS8yZWEz/ZWU5NmM0NTlmNWVj/Mjk1YjBkYjhmZTk0/MTA2YS5qcGc.jpg","author":"MGMA","episode_count":770,"summary":"Welcome to the MGMA Podcast Network, your gateway to insightful discussions and expert analysis on key topics in healthcare management. Dive into a diverse array of shows tailored to meet the interests and needs of healthcare professionals like you. Explore the experiences and perspectives of trailblazing women in healthcare on \"Women in Healthcare,\" or discover innovative strategies and solutions for your practice on \"Business Solutions.\" Stay updated on the latest industry trends and news with \"Week in Review,\" and gain valuable insights from industry leaders and MGMA members on \"Member Spotlight.\" Don't miss our flagship show, \"MGMA Insights,\" where we delve deep into the most pressing issues facing healthcare organizations today. Whether you're seeking inspiration, practical advice, or in-depth analysis, the MGMA Podcast Network is your trusted companion on your journey towards excellence in healthcare management. Tune in and join the conversation today!","last_synced_at":"2026-07-15T14:18:46.381160+00:00","page_url":"https://stenobird.com/podcast/mgma-podcasts-220052"},"episode":{"title":"Leveraging AI Solutions to Modernize Prior Authorization in Medical Practices, with Dr. Paola Ballester","slug":"leveraging-ai-solutions-to-modernize-prior-authorization-in-medical-practices-with-dr-paola-ballester","published_at":"2025-12-10T18:15:50+00:00","page_url":"https://stenobird.com/podcast/mgma-podcasts-220052/leveraging-ai-solutions-to-modernize-prior-authorization-in-medical-practices-with-dr-paola-ballester","show_page_url":"https://stenobird.com/podcast/mgma-podcasts-220052","url":"https://mgma-podcasts.transistor.fm/743","audio_url":"https://media.transistor.fm/8cbf35a4/4a26d599.mp3","summary":"In this episode of the MGMA Insights Podcast , Sr. Editor and host Daniel Williams sits down with Paola Ballester, MD , pediatric hospitalist, medical director for utilization management, and senior physician advisor at a large, freestanding academic children’s hospital and regional pediatric referral center. Dr. Ballester is also the co-founder of EasyPA, an AI-driven platform designed to streamline prior authorization processes. Together, they explore how medical practices can tackle administrative burdens, leverage technology, and prepare for upcoming regulatory changes — all while improving patient access to care. Key Takeaways 02:45 Dr. Ballester’s Unique Journey From insurance claims adjuster to pediatric hospitalist — how her background shaped her expertise in utilization management and revenue cycle. 06:27 The Pain Points of Prior Authorization Why delays in prior auth lead to patient suffering and staff frustration, and why the current system is broken. 08:01 Introducing EasyPA How an AI-powered platform can detect prior auth requirements, reduce denials, and generate appeal letters and peer-to-peer talking points. 11:37 The “220-Minute Case” A real-world example of administrative burden: 19 email threads, 14 team members, and multiple failed appeals for one procedure. 22:19 Preparing for Regulatory Changes CMS’s new rules (57F) will require electronic prior auth by Jan 1, 2027 — what practices need to know now. 17:22 Choosing the Right Tech Tools Practical advice for administrators and clinicians on evaluating AI solutions and understanding your own data before investing. 24:22 Leadership and Representation Dr. Ballester’s advice for women in healthcare leadership: owning confidence, overcoming imposter syndrome, and defining success. 26:35 Life Beyond Medici…","meta_description":"In this episode of the MGMA Insights Podcast , Sr. Editor and host Daniel Williams sits down with Paola Ballester, MD , pediatric hospitalist, medical dir…","key_points":[],"chapters":[],"topics":[],"duration_seconds":1843,"processing_state":"not_requested","actions":[{"name":"request_transcript","method":"POST","url":"https://stenobird.com/v1/public/podcasts/mgma-podcasts-220052/episodes/leveraging-ai-solutions-to-modernize-prior-authorization-in-medical-practices-with-dr-paola-ballester/transcription-requests","description":"Idempotently request low-priority transcript generation for this episode."},{"name":"read_markdown","method":"GET","url":"https://stenobird.com/podcast/mgma-podcasts-220052/leveraging-ai-solutions-to-modernize-prior-authorization-in-medical-practices-with-dr-paola-ballester.md","description":"Read the agent-friendly Markdown representation of this episode resource."}]}}