Issued Friday, the proposed rule also would require full disclosure of claims denials and appeals outcomes, according to a ...

Add Yahoo as a preferred source to see more of our stories on Google. In June of this year, CMS announced that it would be launching the Wasteful and Inappropriate Service Reduction (WISeR) Model, ...

US health insurers have made it easier for doctors to get approval before providing certain types of treatment, industry ...

Add Yahoo as a preferred source to see more of our stories on Google. Artificial intelligence will soon play a role in whether Medicare will pay for Ohioans' pain relief therapy and skin substitute ...

The healthcare industry is on the brink of a transformative shift in the way prior authorizations are managed. Traditionally, prior authorizations have relied heavily on an attestation model, where ...

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prior authorization for procedures should be reported to insurance plans as a CPT code—though that proposal has been withdrawn for now.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., ...

Several health insurers are extending prior authorizations for elective services that have been canceled or deferred because of COVID-19. Blue Cross and Blue Shield of Minnesota shared with Becker’s ...

UnitedHealth has rescinded a plan to require prior authorization for colonoscopies and other endoscopic procedures, following backlash from physician groups. UnitedHealth, which operates the biggest ...

Many physicians and practices say prior authorization is a major administrative burden and have urged lawmakers to institute reforms to the process for commercial and public payers. Nearly 97% of ...

2023 has been a tumultuous year when it comes to prior authorizations, as some payers have repealed major barriers to procedures, while others have added new rules. On Aug. 1, Humana rolled back prior ...

Many health systems and patients have struggled with prior authorization procedures. Prior authorization practices are staying in the spotlight. Health systems are looking for payers to do more to ...

The impact of using AI to evaluate these prior authorizations is unclear. AI could allow tech companies to automatically approve more cases, which could speed up decisions. However, companies could ...