For UnitedHealthcare Medicare Advantage plans, only 2.5% of claims require prior authorization, excluding certain requests, ...

The need to fix healthcare’s antiquated prior authorization (PA) process remains a hot-button issue in the industry, garnering policy attention and spurring the development of myriad technology ...

Each prior auth transaction costs practices between $20 and $30 ...

The new CMS regulations on prior authorization have been heralded as a big step forward in reducing administrative burdens on physicians, but some people think it doesn't go far enough. The CMS ...

In 2026, the Centers for Medicare and Medicaid Services (CMS) will expand prior authorization in the fee-for-service program through the Wasteful and Inappropriate Service Reduction (WISeR) Model.

When Paula Chestnut needed hip replacement surgery last year, a pre-operative X-ray found irregularities in her chest. As a smoker for 40 years, Chestnut was at high risk for lung cancer. A specialist ...

It's no secret that burnout is a struggle across the healthcare industry, and the complex, time-consuming prior authorization process is one contributor. In fact, the U.S. Surgeon General addressed ...

For the first time, more Medicare enrollees received their Medicare benefits through a Medicare Advantage (MA) plan last year than through Traditional Medicare. We saw first-hand at the Center for ...

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 ...

Forbes contributors publish independent expert analyses and insights. Bruce Japsen writes about healthcare business and policy. This article is more than 3 years old. The American Medical Association, ...

Prior authorization companies are moving into ambient listening, while ambient listening companies are expanding into prior authorization — a trend underscored by yet another partnership bridging the ...

It took 13 years of training and education for me to earn a license to practice medicine and perform surgery on the eye. For more than 30 years since, I’ve been attempting to provide the best there is ...