One physician is making the case that prior authorization for procedures should be reported to insurance plans as a CPT code—though that proposal has been withdrawn for now. Alex Shteynshlyuger, M.D., ...

PLANO, Texas, Aug. 20, 2025 /PRNewswire/ -- ZeOmega®, the leading population health management organization, today announced the launch of Smart Auth Optimizer, a machine learning-powered prior ...

Ohio is one of six states testing an AI-led prior authorization program for around a dozen medical procedures for patients ...

The new Medicare initiative would apply to claims for procedures such as steroid injections for pain management, electrical nerve stimulator implants, skin and tissue substitutes, devices for ...

Payer updates and policy changes delay reimbursement; Leaders say automated solutions can help fight back. The tug-of-war between providers and payers over prior authorizations is a consistent and ...

A recent proposal to report prior authorization to insurance plans through CPT codes was withdrawn at the eleventh hour when its physician advocate made an unexpected discovery: For certain codes and ...

Health insurers covering more than 250 million Americans recently unveiled a sweeping plan to streamline and reduce prior authorization requirements — a pledge met with cautious optimism by revenue ...

Everyone’s talking about AI in healthcare — but in revenue cycle management, confusion remains about what it actually does. For RCM and finance leaders, the key question is: What makes an AI solution ...

The Centers for Medicare and Medicaid Services (CMS) recently announced the launch of a program that will require individuals on Medicare to obtain prior approval from the federal health insurance ...

Staff at Arkansas' Harmony Park Family Medicine have been excited about streamlining the prior authorization process with the goal of improving patient access to high-quality care. Prior authorization ...

Imposing a new prior authorization requirement increased the likelihood that older patients with cancer will delay or stop filling their prescription for oral anticancer drugs, a new study showed.

Before selecting a vendor to aid in prior authorization management, health systems should conduct their own "needs assesment," according to Christine Migliaro, VP of front-end revenue cycle operations ...