Massachusetts insurance regulators unveiled sweeping prior authorization reforms that would scrap pre-approval requirements ...

The idea behind it seems reasonable: Insurers want to ensure treatments are medically necessary before they pay for them. But ...

Prior authorizations have long been hated by many, but insurers call them an essential tool they use to control spending.

Company’s chief product officer explains how his company is helping eliminate the technical complexity and manual burden of ...

Every year tens of millions of Americans dig deep into their pocketbooks to pay for health insurance plans that will cover ...

Earlier this year, the Centers for Medicare & Medicaid Services (CMS) announced an agreement with Medicare Advantage plans to lessen the use of prior authorization, but the agency also said it would ...

Picture this: You’re in pain. Your doctor prescribes a treatment. Then nothing. Weeks pass without a word from your insurance company. You call, you wait, you call again. Eventually, you find out your ...

ASC leaders say prior authorization has become the most damaging pain point in payer relationships, delaying care even after clinical decisions are made and surgeries are scheduled. Four ASC leaders ...

Effective Jan. 1, the Trump administration will, for the first time in the 60-year history of Medicare, implement a pilot project in six states (with Ohio being one of them) that will use private, for ...