I Solved "Prior Authorization" with this One Weird Trick

Thinking like a payor to solve the problem

I had insomnia last night. Documented below:

And…cracked a (conceptual) nut. No, it wasn't about not sleeping. It was about how to solve prior authorization.

A little background, for general audiences. Big Health companies, which we have traditionally referred to as “insurance” companies do a heck of a lot more than insure. What started out as a way to make hospitalization not devastatingly costly grew into the giant corporate behemoths that we have today. Take a minute with the pluralization of the word behemoth.

The original behemoth was of course a giant land creature first mentioned in the Bible in the book of Job. It turns out, behemoth was the first of God's creations. It's supposed to be the biggest thing. It's not supposed to be plural. Here's what it says in the Bible (Job 40:15-19):

“Behold, Behemoth, which I made as I made you;

he eats grass like an ox.

Behold, his strength in his loins,

and his power in the muscles of his belly.

He makes his tail stiff like a cedar;

th…