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 ...

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 ...

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 ...

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 ...

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 ...