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prior authorization for procedures should be reported to insurance plans as a CPT code—though that proposal has been withdrawn for now.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

There are 5 steps to prior authorization when looking at it from a best practice standpoint. These steps include demographics, eligibility, determination, submission, and status retrieval. Tune into ...

Massachusetts regulators would eliminate many prior authorization rules, speed urgent approvals and form a working group to ...

To combat growing criticism of prior authorization delays by payers, Centers for Medicare & Medicaid Services finalized a rule Wednesday that requires health plans to send prior authorization ...

One increasingly subtle but important theme in US healthcare is the shift to care allocated by payers rather than providers. Historically, decisions on what care to provide patients were made by ...

Prior authorizations have long been hated by many, but insurers call them an essential tool they use to control spending.

Everyone’s talking about AI in healthcare — but in revenue cycle management, confusion remains about what it actually does. For RCM and finance leaders, the key question is: What makes an AI solution ...

This is a preview of Access Health—Tap here to get this newsletter delivered straight to your inbox. Newsweek hosted its first Women's Global Impactforum on Tuesday, and health care was a hot topic.

Please provide your email address to receive an email when new articles are posted on . Attempts to curtail prior authorizations for patients insured by Medicare Advantage plans have failed in back-to ...

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 ...

Experimental model is being called an "AI death panel," congressman says ...