Prior authorization is a process health insurers use to determine whether they will cover a prescription, medical procedure, ...

Preauthorization is about to enter the lives of many seniors who have chosen traditional Medicare over MA, write former CMS ...

Johns Hopkins Medicine and UnitedHealthcare are at odds over an agreement that would keep the insurer’s health coverage in ...

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 ...

Humana, the second-largest provider of Medicare Advantage Plans, has pledged to streamline the often frustrating Prior ...

A bill intent on reforming the pre-authorization process in Delaware passed both chambers and is now under consideration from ...

There's a lot of hype around the potential for new technologies to fix the prior authorization process, but this rev cycle ...

Humana said on Tuesday it would eliminate about one-third of prior authorizations for outpatient services by next year, the ...

New survey results from the AMA illustrate the burden of prior authorization, with many physicians reporting that it leads to serious patient harms, delays care, reduces work productivity and more ...

However, in December 2022, CMS proposed its own prior authorization regulations that included many of the provisions in that first version, such as mandating that "impacted payers" -- including MA ...

UPDATED: Thursday, May 9 at 5:50 p.m. | A New York urologist believes prior auth CPT codes will realign incentives and better support patients and physicians.

Delays in prior authorization can in turn delay treatment — and therefore relief — for suffering patients. (While the majority of prior authorization requests are approved, the share of denials is ...