My wife runs a small medical clinic. In the past, she worked as a physical medical biller contracting for large hospital systems, which gives her an unusually

My wife runs a small medical clinic. In the past, she worked as a physical medical biller contracting for large hospital systems, which gives her an unusually good understanding of how to submit a good claim to an insurance company. Despite this, for every hour of patient care, there's an addition 90-120 minutes of staff time to deal with insurance companies, plus additional time spent by a third party (who bills on a percentage, so we don't know exactly how much time they spend). That third party consistently complements her billing staff at being unusually good. Sometimes a claim is denied because the insurer says they need additional documentation when that documentation was already provided. Sometimes this happens more than once. Sometimes prior authorization requests get "lost". I think the problem is that if an insurer wrongly denies claims some of the time, nothing bad happens to them but they might save some money. The only fix I see is to change the rules of the system so that it the insurer gets no financial advantage for wrongly denying claims.