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

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

The Centers for Medicare & Medicaid Services (CMS) has been using prior authorization for selected Hospital Outpatient Department (OPD) services ...

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 ...

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 ...

Blue Shield is designing a centralized, machine-readable policy repository to enhance policy digitization and automation, speeding up prior authorization decisions. The organization has partnered with ...

Elisa Auguste, administrator at East Setauket, N.Y.-based Precision Care Surgery Center and vice president of the New York ...

Kansas Insurance Commissioner Vicki Schmidt stated the prior authorization process in health care is "definitely broken." Schmidt indicated to lawmakers that any legislative efforts to reform the ...

In a recent survey by revenue cycle management company FinThrive, 73 percent of respondents said they are using AI and automation to streamline prior authorization. To meet this demand from health ...

BOSTON (SHNS) – State insurance regulators unveiled sweeping prior authorization reforms that would scrap pre-approval requirements for “many routine and essential” health care services, Gov. Maura ...