Long-running efforts to limit health plans' ability to deny or delay physician-ordered care are on hold again, despite ...

Optum is rolling out new AI-powered tools that aim to reduce delays associated with prior authorization. | Optum is rolling out new AI-powered tools that are aimed to reduce delays associated with ...

"Medically necessary" is often a four-letter word for patients.

The CMS Final Rule signals a future in which prior authorization isn’t just faster but fairer. AI has the potential to accelerate decisions, lower administrative costs and support equitable access to ...

Rheumatologists share how they are using AI platforms for clinical documentation, reducing EHR time, streamlining workflows, ...

Commercial insurers denied roughly one out of every five claims submitted in 2024, with administrative issues driving a large ...

Payer scrutiny in spine and orthopedic care is intensifying, and surgeons say the biggest barriers to care come not from clinical uncertainty, but from rigid algorithms, prior authorization delays and ...

To make it happen, plans should start by offering true outreach flexibility, including live calls, mail, SMS, and digital options. They must let response data drive the next step (eg, text after a ...

In advance of any diamond drilling, the Company is planning an open-door information meeting with the Atikamekw of Wemotaci ...

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