The burden of prior authorizations (PA) has been a topic of discussion for quite some time due to concerns that the current process burdens providers and slows down care delivery. Providers continue ...

Provider groups say new reforms proposed by the Biden administration to streamline prior authorization are a good start. But much more needs to be done—including creating gold-card programs that let ...

Providers are betting on artificial intelligence to ease the pain point of prior authorization, a new survey shows. Cohere Health, which provides clinical intelligence to insurers and risk-bearing ...

Prior authorization is a complex, expensive and burdensome process with clinical and financial impacts across the spectrum of care. Built on processes that are mostly manual, even partial automation ...

Payers and providers came out in support of a new rule from the CMS proposing requirements on certain health insurers in a bid to improve the prior authorization process, though provider groups say ...

A six-state pilot program will target “wasteful care” under Medicare, Centers for Medicare & Medicaid Services says.

Medicare providers participating in and payers offering Part C and Part D plans are facing increasing pressure to move into the 21st century, and the government is taking decisive steps to ensure this ...

BELLEVUE, Wash.--(BUSINESS WIRE)--Edifecs, Inc., a global health information technology solutions company and VirtualHealth, an industry-leading medical management technology company, today announced ...

Almost 80% of physicians surveyed by the AMA say patients are skipping care because of delays in prior authorizations. Prior authorizations are a consistent pain point in revenue cycle operations, and ...

An online survey identified that documentation requirements and communication issues with health plans are associated with providers modifying clinical decisions to avoid medication prior ...

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 ...

Vermont's health care providers have taken aim at health insurance companies, targeting excessive bureaucracy, and the practice of requiring prior authorization for needed procedures and drugs, as ...