The former chief medical officer for UnitedHealth Group says the harsh reaction to Brian Thompson’s killing shows the ...

Hurley was all too familiar with the administrative burden that prior authorization places on doctors’ offices, often ...

The most familiar example is prior authorization, a process through which health plans verify a procedure, prescription or other clinical service will be covered by the patient's health plan ...

Key Takeaways The rate of Medicare Advantage (MA) claims has escalated in recent years, prompting medical and government ...

This collaboration is not only designed to provide tailored prior authorization services but further addresses the unique challenges of managing a seamless physician billing operation. Tackling ...

To add another twist: Cigna owns a prior-authorization shop, eviCore, which is buried deep within its corporate structure. (It falls under the umbrella of Evernorth Health Services, Cigna’s ...

Amid widespread concern about the use of AI for prior authorization requests, the regulation states insurers that automate reviews would be required to "provide equitable access to services and ...

Increasingly, doctors attempting to get their patients necessary medications, devices and procedures find their efforts stymied by a labyrinth of “prior authorization” hurdles created by ...

You don’t need prior authorization when you receive services from an out-of-network provider. Given that 99% of Medicare Advantage members are in plans that require authorization, this could be ...

Officials at the The Centers for Medicare & Medicaid Services said they would impose further limits on MA insurers’ use of prior authorization and artificial intelligence as part of a wide ...

Congress reached a tentative budget deal Tuesday that largely -- but not entirely -- reversed a 2.8% cut in the Medicare ...