Prior authorization refers to when medical providers have to get approval from insurers before performing a service. Patients ...

Delays in prior authorization can in turn delay treatment — and therefore relief — for suffering patients. (While the majority of prior authorization requests are approved, the share of denials is ...

Beginning next year, the CMS will launch an AI-powered prior authorization process for some services as it seeks to cut funding for what it deems medically unnecessary care.

As payers announce plans to improve prior authorizations, two spine surgeons discuss the changes that would make the most difference for them. Ask Spine Surgeons is a weekly series of questions posed ...

Across the healthcare landscape, prior authorization is undergoing significant changes aimed at reducing administrative burden and expediting care delivery. Here are three major updates to know: 1.

Namasivayam said that Cohere is well-positioned to help payers comply with this rule. “With Cohere’s intelligent prior authorization technology, 83% of requests are immediately approved.

According to a National Conference of State Legislatures database, 23 states enacted more than 43 bills related to prior authorization in the last few years, with 18 enacted so far in 2024 alone.

When it comes to Medicare Advantage plans you need to understand prior authorization. getty. My 90-year-old uncle, a retired county employee, has had a Medicare Advantage preferred provider ...

The prior authorization process is a lengthy one, in which denials and appeals are often repeated several times for each patient. As one nurse told me: “the insurance company fights to deny, ...

Prior authorization is a complicated, time-consuming, “cost-control process” utilized by health insurance companies that requires physicians to obtain advanced approval from them before a ...