The planned cuts come as payers face ongoing pressure to reduce prior authorization use. For example, a recent initiative led ...

Aligning electronic data submission requirements for prior authorizations is one prong of the insurance industry’s commitment ...

With denial rates at 4 percent in 2025, the Dallas-based, tech-forward insurer is outperforming national averages.

Prior authorization is the process by which your doctor must request approval from your Medicare plan before they can order a particular medication or medical service. Generally, Original Medicare ...

Participating payers reported an 11% reduction in prior authorization requirements overall, with Medicare Advantage exceeding ...

It’s another busy day in my spine surgery clinic when my phone rings. Patients are waiting, but I’d be unwise to put off the caller: a physician calling from a health insurance company. This ...

Recently, we put together a template to help medical professionals explain a confusing process. Readers gave us very pointed feedback, so we updated it. By Ron Lieber Two months ago, I shared my tale ...

Forbes contributors publish independent expert analyses and insights. Jesse Pines is an expert in healthcare innovation and wellness. This voice experience is generated by AI. Learn more. This voice ...

People walk inside a Medicare Services office in New York City. Reporter Some Medicare recipients are set to experience a new “prior authorization” measure as the Centers for Medicare & Medicaid ...

A Surescripts-led pilot has shown that medication prior authorization can be processed in as little as 18 seconds without AI, sharply reducing denials and appeals. The program’s expansion across 20 ...

Jaclyn Mayo has multiple sclerosis, an autoimmune disease that damages the nervous system and can mess with coordination and balance. To get steadier on her feet, Mayo had been trying to lose weight: ...