Strengthen your financial backup. Even with Medicare coverage, unexpected out-of-pocket expenses can pop up. Earn as much as ...

The AI-powered prior auth requirements under the CMS' Wasteful and Inappropriate Service Reduction model would increase ...

Why Prior Authorization Still Matters When you join a Medicare Advantage plan, your care sometimes requires an extra step ...

Practicing physicians know all too well how prior authorization can disrupt the delivery of smooth, timely patient care. It’s a common cause of delays, administrative hurdles, and immense frustration ...

If you’ve ever been a patient waiting—days, sometimes more than a week—for treatment approval, or a clinician stuck chasing it, you know what prior authorization feels like. Patients sit in limbo, ...

When you are sick or in pain, the prior authorization process can be frustrating and will sometimes result in a denial. If you've never been through the process, prior authorization is a requirement ...

While there's a lot of buzz around prior authorization, it applies to fewer than 2% of claims. Prior authorization ensures care is both safe and aligned with the most up-to-date clinical guidelines.

The new Medicare initiative would apply to claims for procedures such as steroid injections for pain management, electrical nerve stimulator implants, skin and tissue substitutes, devices for ...

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 ...

Few readers would be surprised to read that Americans are dissatisfied with their health care coverage — an outrage that the December 2024 assassination of UnitedHealthcare CEO Brian Thompson arguably ...

AHA has “substantial concerns” over the vendor payment structure in WISEeR that incentivizes denials at the expense of ...