UnitedHealthcare, CVS Health and Humana had the highest denial rates for long-term care requests, according to a report from ...

Medicare Advantage prior authorization (PA) is the process you go through to get certain services and drugs approved before you receive them. The process can be frustrating, as it can take up to 14 ...

The requirements will make exchanging health data more efficient and reduce administrative burden. Today CMS finalized the Interoperability and Prior Authorization Final Rule, continuing its efforts ...

Prior authorization has emerged as a flash point between payers and providers as the former tries to manage what they believe is waste in the system while the latter accuses payers of trying to deny ...

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Medicare Advantage Organizations overturned 95% of appealed prior authorization denials for skilled nursing facility admission in favor of enrollees, raising concerns that some beneficiaries were ...

Physicians groups on January 17 hailed a new federal rule requiring health insurers to streamline and disclose more information about their prior authorization processes, saying it will improve ...

Prior authorization requirements cost the U.S. healthcare system an estimated $35 billion each year, and their overuse has triggered a backlash, stirring some policymakers into action. Whether these ...

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Research indicates that prior authorizations for drugs take physician practices and pharmacies 15 to 64 minutes to complete ...

Over 35 million prior authorization requests were submitted to Medicare Advantage insurers in 2021, according to a new report from the Kaiser Family Foundation (KFF). Two million of these requests, or ...

Most ABA practices track new patient volume, but few track what percentage of received referrals actually convert to a ...