Prior authorization is the process by which your doctor must request approval from your Medicare plan before they can order a particular medication or medical service. Generally, Original Medicare ...

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 ...

Prior authorization has become one of the clearest points where administrative complexity directly affects patient care. For ...

Traditional Medicare, also known as original Medicare, has historically required little in the way of pre-authorization for beneficiaries seeking services; pre-authorization was typically the domain ...

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 ...

Abridge and Availity are partnering to develop a real-time prior authorization experience integrating utilization management directly into the clinician/patient conversation to streamline interactions ...

UnitedHealthcare today announced more than half of its prior authorization volume will be included in an industrywide effort to standardize submission requirements for electronic prior authorization, ...

There is a good reason for health insurers to occasionally require prior authorization for medical treatment. If a doctor prescribes an unusual, experimental, or expensive medication or procedure, the ...

Ask a provider what’s causing tension in their relationship with insurers and many will point to prior authorization, arguing that the practice creates administrative burdens and delays in patient ...