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 ...

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 ...

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 ...

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 ...

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 ...

Insurers designate certain prescription drugs with prior authorization to ensure safe and medically appropriate use but also to contain costs. Here, a healthcare provider must obtain approval from a ...

Many physicians believe prior authorization gets in the way of sound patient care. New reforms from the insurance industry aim to address these challenges. Will they make a difference? You learn a lot ...

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 ...