Medicare Advantage plans use prior authorization to manage health care use. In recent years, these practices have come under intense scrutiny from policy makers. Using beneficiary enrollment data and ...

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Prior authorization is the process through which a doctor seeks approval from a person’s health insurance plan before ordering a specific medication or medical service. Original Medicare (parts A and ...

Recently, we put together a template to help medical professionals explain a confusing process. Readers gave us very pointed feedback, so we updated it. By Ron Lieber Two months ago, I shared my tale ...

Ramya Ganti is the founder and CEO of Oprox, a VC-backed AI-native revenue intelligence platform for healthcare providers.

Health insurer Humana has said it’s engaging in efforts to streamline the prior authorization process, in part by approving care requests as quickly as possible and reducing the administrative burdens ...

Medicare is testing the use of artificial intelligence to preapprove several healthcare services.

A new CMS proposed rule would reduce the burden of prior authorizations by further shortening payer decision timeframes and ...

UnitedHealthcare is eliminating authorization requirements for 30% of healthcare services that previously required insurer approval, the nation's largest insurer said. Prior authorization is currently ...

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 ...