Payers prior authorization denial rates must be publicly reported starting March 31, 2026, improving transparency for Medicare Advantage and ...

But making sense of the numbers isn't easy, experts say ...

Six months after Eric Tennant died following a protracted battle with his health insurer over doctor-recommended cancer care, ...

Each prior auth transaction costs practices between $20 and $30 ...

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 ...

While major provider organizations welcomed insurers' pledge earlier this week to reform prior authorization, these groups withheld praise without yet seeing the efforts bear fruit. Bobby Mukkamala, M ...

The Electronic Frontier Foundation is seeking more information on the government’s agreements with participating vendors, ...

HB 4965 permits switching to an alternative medically appropriate treatment of equal or lesser value after initial approval, ...

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 ...

While the AHA has called on CMS to rethink its plan to add prior authorization requirements to traditional Medicare, some argue that the program is due for some utilization management. CMS has sparked ...

There are 5 steps to prior authorization when looking at it from a best practice standpoint. These steps include demographics, eligibility, determination, submission, and status retrieval. Tune into ...