Field notes.
How specialty practices are running ERA reconciliation, prior auths, denial workflows, and RCM operations on Foresight — in their own words and numbers.
Why Your ERA and Bank Deposit Don't Match — and What Specialty Clinics Should Do About It
Your ERA shows $12,400 paid on Tuesday. Your bank statement shows $11,847 landing Thursday. Here's why that gap exists at specialty practices — and how to build a reconciliation workflow that catches it.
ReadPLB Segments in 835 ERA Files: Why Auto-Match Plateaus at 80% in Specialty Clinics (and How to Fix It)
Why PLB adjustments break ERA auto-posting at specialty clinics. A field guide to FB, WO, L6, and 72 reason codes, recoupment timing, and the BPR balancing equation that closes auto-match gaps.
ReadCMS Prior Authorization Transparency Is Live. Here's How Specialty Clinics Should Use the New Data
CMS-required prior authorization reports are now starting to appear, but the data is easy to misuse. Here's how specialty clinics should interpret the new metrics and turn them into payer-specific workflows.
ReadWhy ERA/835 Reconciliation Breaks at Specialty Clinics
Specialty clinics hit remittance failures generic PM workflows don't handle well. Here's where ERA/835 reconciliation breaks, from enrollment and routing to line-level matching and EFT reassociation.
ReadCigna TMS Prior Authorization Removal in 2026: What Billing Teams Need to Change Now
Cigna/Evernorth removed TMS prior authorization for contracted providers under Evernorth and Cigna Healthcare plans on March 6, 2026. Here’s what changed, what didn’t, and how billing teams should respond.
ReadGLP-1 Prior Authorization: What Clinic Teams Need in 2026
A practical 2026 guide to GLP-1 prior authorization requirements by payer and PBM. Covers Wegovy, Zepbound, and Mounjaro workflows, recurring payer questions, denial patterns, turnaround times, and a clinic-ready submission checklist.
Readhow Foresight Automates rcm: What Actually Works
Every week, we hear the same question from telehealth providers: "Should we use rules-based automation or AI for our revenue cycle?" It's the wrong question. Here's why: A Parkinson's disease telehealth visit generates a predictable pattern. The prov…
ReadThe 2025 RCM competitive landscape: Foresight vs. incumbents, AI-native startups, and niche players
A $172B RCM market split between legacy BPO incumbents and narrow AI point solutions — and where Foresight fits as the end-to-end automation layer for specialty telehealth.
ReadCase Study: Automating RCM for a Specialized Infectious Disease Clinic
A specialized infectious disease clinic, managing a high-touch patient population of hundreds of patients was struggling with a disjointed Revenue Cycle Management (RCM) process. Relying on third-party contractors and antiquated manual workflows, the c…
ReadAutomating High-Volume Pharma Prior Authorization
Our client, a leading digital weight-loss clinic, faced a critical operational bottleneck: their rapid growth was outpacing their ability to process medication approvals. With 100,000+ GLP-1 prescriptions annually (e.g., Wegovy, Ozempic), they relied o…
ReadComparing Top RCM & Prior Authorization Solutions
Article comparing top and specialist medical RCM and prior auth vendors in the US
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