These health care hurdles can stand in the way of getting treatment your doctor says you need. Here's what to know about how ...

Please provide your email address to receive an email when new articles are posted on . UnitedHealthcare recently announced that beginning June 1, 2023, commercial plan members will be required to ...

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 ...

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 ...

For a patient beginning cancer treatment, time matters. Utahns should not have to guess what criteria determine whether their ...

LAS VEGAS—Blue Shield of California and Salesforce are teaming up to simplify and streamline the prior authorization experience. The partners announced at HLTH on Monday that they would leverage ...

Over 35 million prior authorization requests were submitted to Medicare Advantage insurers in 2021, according to a new report from the Kaiser Family Foundation (KFF). Two million of these requests, or ...

Sometimes certain types of specialty care and prescription drugs require special review called prior authorization to make sure they are right for the patient. Prior authorization is a standard ...

The cost of prior authorization requirements on physician practices has continued to increase—up 60% in 2019 to manually generate a request to insurers. The just released CAQH 2019 Index, which ...

Traditional Medicare, also known as original Medicare, has historically required little in the way of pre-authorization for beneficiaries seeking services; pre-authorization was typically the domain ...

Don't let insurance delays stall your ulcerative colitis remission. Learn how to navigate prior authorization, step therapy, and specialty pharmacy hurdles.