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 ...

The six-year WISeR Model trial begins January 2026, affecting traditional Medicare recipients seeking certain medical ...

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 ...

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, ...

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.

Navigating the healthcare system can be a complex and frustrating experience for many patients. Among the many challenges, one of the most insidious barriers to timely care is prior authorization.

"These shortages aren't just about an insufficient supply; they're fueled by burnout," said Dr. Paola Ballester, MD, ...

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 ...

As congressional Democrats and Republicans battle over how to avert a potential government shutdown, another issue -- reining in prior authorizations -- remains on both parties' radar screens, ...

If you are covered by a Medicare Advantage plan, you may have been required to secure prior authorization before a medical ...

Called "prior authorization," the process is more common in private insurance and can lead to delayed and denied care. About 93% of physicians said prior authorization delayed their patients' access ...

The Hawaii Supreme Court has cleared the way for customers of the state’s largest health insurance company to sue over ...