One physician is making the case that prior authorization for procedures should be reported to insurance plans as a CPT code—though that proposal has been withdrawn for now. Alex Shteynshlyuger, M.D., ...

In a recent survey, 84% of providers reported the number of medical services that require prior authorization has increased. And 62% of providers reported that they do not have the technology to ...

Pitcher Mark Prior is attempting to resurrect his career in San Diego. "I understand the challenge and the road I’m facing," he said. ( (Jamie Squire/Getty Images) PEORIA, Ariz. – We are suckers for ...

Prior authorization has long been a sticking point between payers and providers, with payers arguing that it’s necessary to control costs and ensure that care is medically necessary and providers ...

Payers have new deadlines to issue prior authorization decisions — 72 hours for urgent requests and seven days for non-urgent ones. Prior authorization is a process wherein a doctor must get approval ...

The broader health insurance industry has announced a series of commitments to streamline, simplify and reduce prior authorization requirements across commercial, Medicare Advantage and managed ...

Forbes contributors publish independent expert analyses and insights. Jesse Pines is an expert in healthcare innovation and wellness. Health insurer prior authorization has increased considerably in ...

Physicians surveyed by the AMA say that PA can cause care delays or force patients to abandon treatment. They warn denials could increase as insurers adopt AI to review claims. Physicians have long ...

A year ago, the fatal shooting of a health insurance executive on a Manhattan sidewalk unleashed many Americans’ pent-up frustration with insurers’ delays and denials of care. UnitedHealthcare CEO ...

A look at the rise of prior authorization certified specialists (PACS)—and their value in improving patient access and outcomes. The healthcare industry constantly grapples with the challenge of ...

Prior authorizations create substantial administrative and financial burdens on physicians and patients and can disrupt the continuity of care. This commentary discusses the current prior ...