The proposed rule could amplify the meaningful progress made by healthcare technology innovators and provide a more ...

Physician groups are urging the Trump administration to give them more information on insurance companies’ pledges to change ...

Checkpoints exist throughout the American health care system. They ensure people receive appropriate care and avoid preventable errors in treatment or diagnoses. While doctors and hospitals manage ...

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 ...

Picture this: You’re in pain. Your doctor prescribes a treatment. Then nothing. Weeks pass without a word from your insurance company. You call, you wait, you call again. Eventually, you find out your ...

Legislation aimed at reducing delays when Medicare Advantage plans require preapproval for care could hit the House floor ...

Prior authorization is a process that involves contacting a person’s Medicare provider to request coverage for a medical service, drug, or piece of equipment. If a person has Original Medicare (parts ...

Traditional Medicare plan holders have typically not had to wait for prior authorization before receiving medical treatment. Until now. The Centers for Medicare & Medicaid Services (CMS) recently ...

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

Remember that physician who wanted to develop a Current Procedural Terminology (CPT) code for prior authorizations? It hasn't happened yet, but he hasn't given up on it, either. In May, Alex ...

UnitedHealthcare, the largest private payer in the U.S., plans to eliminate almost 20% of its current prior authorizations starting this summer, the company announced Wednesday. The decision, which ...