Beginning next year, the CMS will launch an AI-powered prior authorization process for some services as it seeks to cut ...

Prior authorization refers to when medical providers have to get approval from insurers before performing a service. Patients ...

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 ...

Prior authorization is the process by which your doctor must request approval from your Medicare plan before they can order a particular medication or medical service. Generally, Original Medicare ...

The largest U.S. insurers agreed Monday to streamline their often cumbersome preapproval system. Here are five takeaways.

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 ...

Some insurers' efforts to improve prior authorization practices aren't as helpful as they would seem, said Judson Ivy, CEO of Ensemble Health Partners, a revenue cycle management company.

Medicare Advantage plans prior authorization denial rates and success rate of overturning denial on appeal In 2023, insurers fully or partially denied 6.4%, or 3.2 million, prior authorization ...

Given these alarming statistics, the End Burnout Group (EBG), a multi-disciplinary group of clinicians and informaticists which we lead, identified prior authorization as a leading root cause of ...

The new CMS regulations on prior authorization have been heralded as a big step forward in reducing administrative burdens on physicians, but some people think it doesn't go far enough.

A House Republican has proposed a simple way to end complaints about health plan prior authorization programs: eliminate health plan prior authorization programs. Rep. Jeff Van Drew, R-N.J., has ...

For patients and doctors, insurance prior authorization can be a dangerous game | Opinion But it is not a game. For one of our leukemia patients, he lost time fighting to get pain medication ...