Have you ever walked into the pharmacy and been told that your prescription requires a prior authorization? But your healthcare professional prescribed something for you, and you brought in your ...

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 ...

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 ...

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

Delaware's Pre-Authorization Reform Act aims to streamline the pre-authorization process for medical procedures and medications. The current process is criticized for being time-consuming, complex, ...

The U.S. Department of Health and Human Services has secured a pledge from insurers to streamline the companies’ practice of requiring prior authorizations before covering a claim. “Americans ...

Concurrent review is a utilization review process that occurs while a patient is actively receiving treatment, such as during a hospital stay. It evaluates the medical necessity and appropriateness of ...