In this eye-opening episode, Dr. Asha Voss sits down with Ethne Nance, EstrogenicA’s RCM partner, to unpack a troubling trend affecting private practices across the country: insurers downcoding physician-submitted claims and in effect, overriding the clinical judgment of providers. From invalidating high-level visit codes to denying prior authorizations for medically necessary procedures, payers are increasingly inserting themselves into the clinical process, often without accountability.Ethne brings real-world clarity to what this means for physicians, patients, and practice sustainability. Together, they explore how these decisions impact cash flow, patient care, and physician autonomy. In return, shares how an RCM partner can become a critical line of defense. With the EstrogenicA MSO model as the backdrop, the conversation highlights the importance of proactive coding support, payer negotiations, and system-wide trust.If you’ve ever wondered why a claim didn’t pay what it should or why a specialist can’t get approval to prescribe what a patient truly needs, this segment makes it plain: it’s not just about billing. It’s about the future of medicine.

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