The requirements will make exchanging health data more efficient and reduce administrative burden. Today CMS finalized the Interoperability and Prior Authorization Final Rule, continuing its efforts ...

UnitedHealthcare, CVS Health and Humana had the highest denial rates for long-term care requests, according to a report from ...

Forbes contributors publish independent expert analyses and insights. Jesse Pines is an expert in healthcare innovation and wellness. This voice experience is generated by AI. Learn more. This voice ...

UnitedHealth Group subsidiary and MAO contractor NaviHealth processed half of all SNF admission requests in the review and ...

Prior authorization requirements cost the U.S. healthcare system an estimated $35 billion each year, and their overuse has triggered a backlash, stirring some policymakers into action. Whether these ...

Prior authorization has emerged as a flash point between payers and providers as the former tries to manage what they believe is waste in the system while the latter accuses payers of trying to deny ...

Medicare Advantage prior authorization (PA) is the process you go through to get certain services and drugs approved before you receive them. The process can be frustrating, as it can take up to 14 ...

Physicians groups on January 17 hailed a new federal rule requiring health insurers to streamline and disclose more information about their prior authorization processes, saying it will improve ...

Please provide your email address to receive an email when new articles are posted on . Be meticulous in checking the accuracy of your applications before submitting them. Use resources from the ACAAI ...

A new federal watchdog report dings the three largest Medicare Advantage insurers for frequent prior authorization denials ...

Prior authorization is a process that involves contacting a person’s Medicare provider to request coverage for a medical service, drug, or piece of equipment. If a person has Original Medicare (parts ...