At the same time, major insurers have pledged to reduce the scope of services subject to prior authorization, improve transparency and ensure 90-day continuity of authorizations when consumers switch ...

Surescripts®, the nation’s leading health intelligence network, released new data illustrating significant impact of solutions, including Prior Authorization Automation and Real-Time Prescription ...

The proposed rule could amplify the meaningful progress made by healthcare technology innovators and provide a more ...

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 ...

Prior authorization has long been a sticking point between payers and providers, with payers arguing that it’s necessary to control costs and ensure that care is medically necessary and providers ...

Prior authorization is a common utilization-management tool among Medicare Advantage plans. However, service-, area-, and carrier-level patterns suggest variation in how plans use prior authorization.

Research indicates that prior authorizations for drugs take physician practices and pharmacies 15 to 64 minutes to complete ...

Checkpoints exist throughout the American health care system. They ensure people receive appropriate care and avoid preventable errors in treatment or diagnoses. While doctors and hospitals manage ...

Zack Sigel is a writer and editor based in New York City. He has been managing editor at Policygenius and M1 Finance, where he led teams specialized in writing about business and finance, and he has ...

Jaclyn Mayo has multiple sclerosis, an autoimmune disease that damages the nervous system and can mess with coordination and balance. To get steadier on her feet, Mayo had been trying to lose weight: ...

For many in long-term care, Monday’s announcement about voluntary prior authorization reforms reeks of unpleasant déjà vu. That’s because they’ve been denied before. In 2018, several major insurers ...