The Biden administration released a proposal which, if finalized, would mandate Medicare Advantage (MA), Medicaid managed care, Affordable Care Act (ACA) plans and state Medicaid agencies implement ...

Electronic health record providers are starting work that could transform how nursing homes grapple with prior authorization requests and length of stay determinations.

It's no secret that burnout is a struggle across the healthcare industry, and the complex, time-consuming prior authorization process is one contributor. In fact, the U.S. Surgeon General addressed ...

Payers have new deadlines to issue prior authorization decisions — 72 hours for urgent requests and seven days for non-urgent ones. Prior authorization is a process wherein a doctor must get approval ...

If there’s one thing healthcare providers can agree on, it’s that prior authorization management is a heavy administrative burden and only growing heavier. Decades ago, it was created to ensure care ...

This article originally appeared on Undark. Last December, a young patient was admitted to Nationwide Children’s Hospital in Columbus, Ohio, after several medications had failed to quell the child’s ...

Highmark was among more than 50 health insurers who pledged Monday to speed up and slim down prior authorization, the process through which patients and their doctors must seek insurance approval for ...

Under a final rule released today, impacted payers will be required to send prior authorization decisions within 72 hours for urgent requests and seven calendar days for standard requests. The Centers ...

Insurance companies often make doctors ask their permission before treating patients. This template can help medical professionals explain how it works. By Ron Lieber Ron Lieber will update this ...

As the year comes to a close, the Trump administration seems to be going in two different directions when it comes to the use of prior authorization in Medicare. On the one hand, there is the effort ...

A year ago, the fatal shooting of a health insurance executive on a Manhattan sidewalk unleashed many Americans’ pent-up frustration with insurers’ delays and denials of care. UnitedHealthcare CEO ...