Few readers would be surprised to read that Americans are dissatisfied with their health care coverage — an outrage that the December 2024 assassination of UnitedHealthcare CEO Brian Thompson arguably ...

While there's a lot of buzz around prior authorization, it applies to fewer than 2% of claims. Prior authorization ensures care is both safe and aligned with the most up-to-date clinical guidelines.

If you’ve ever been a patient waiting—days, sometimes more than a week—for treatment approval, or a clinician stuck chasing it, you know what prior authorization feels like. Patients sit in limbo, ...

Prior authorization is the process through which a doctor seeks approval from a person’s health insurance plan before ordering a specific medication or medical service. Original Medicare (parts A and ...

Health insurance companies will have to invest in technology and update their administrative processes to comply with new prior authorization requirements. The Centers for Medicare and Medicaid ...

Nearly seven months after the fatal shooting of an insurance CEO in New York drew widespread attention to health insurers’ practice of denying or delaying doctor-ordered care, the largest U.S.

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 ...

A pilot program testing the use of artificial intelligence to expand prior authorization decisions in Medicare has providers, ...

Traditional Medicare plan holders have typically not had to wait for prior authorization before receiving medical treatment. Until now. The Centers for Medicare & Medicaid Services (CMS) recently ...

Recently two members of our family had to obtain prior authorization from their health insurance. One person wanted a knee replacement by an orthopedic surgeon and his request was approved; the other ...

To control costs, nearly all health insurers use a system called prior authorization, which requires patients or their ...