Hospital Physician Advisor Overturns 78% of Payer Denials Across 11-Hospital System
Dr. Maliha Iqbal, physician advisor at Beacon Health System, completed 5,118 utilization reviews in 2025 as the sole physician advisor across 11 hospitals, overturning 78% of peer-to-peer denials. The workload doubled following a health system merger. The article profiles operational practices for managing high-volume utilization review and payer denial appeals at scale. This reflects ongoing provider strategies to combat managed care prior authorization and medical necessity denials.
High denial overturn rates at peer-to-peer review indicate potential weaknesses in MCO initial determinations and underscore provider frustration with utilization management — an issue state Medicaid agencies and regulators are increasingly scrutinizing.
Managed Care
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