Major insurers say they’ll ease up on the prior-authorization practice that can delay necessary care for patients.

Highmark is among the more than 50 health insurers who pledged Monday to speed up and slim down prior authorization, the ...

While you don’t need to be involved, you can call to check the status of your prior authorization request. Where you call depends on your plan. With Original Medicare, you can call 800-MEDICARE ...

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

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.

The model will leverage AI and machine learning for prior authorization of services vulnerable to fraud or inappropriate use, ...

CMS has unveiled the Wasteful and Inappropriate Service Reduction model, a new Innovation Center initiative that will add prior authorization for some traditional fee-for-service Medicare services.

Last year, only 26% of the provider groups UnitedHealthcare works with submitted more than one prior authorization request, Docimo said. "It may be perceived as prevalent, but it's not required in ...

For many in long-term care, Monday’s announcement about voluntary prior authorization reforms reeks of unpleasant déjà vu. That’s because they’ve been denied before.

The new CMS regulations on prior authorization have been heralded as a big step forward in reducing administrative burdens on physicians, but some people think it doesn't go far enough.

A July 2023 analysis by the Department of Health and Human Services found that Medicaid managed care organizations denied 12.5% of prior authorization requests, compared to a 5.7% denial rate ...