Dozens of health insurers have made a series of commitments to improve and reduce prior authorization, payer advocacy organization AHIP announced on Monday. The practice is often a point of contention ...

Administrative costs are estimated to make up between 20 and 34 percent of US health care expenditures, roughly 1–4 percent of GDP. Academic and policy discussions generally characterize these costs ...

If you’ve ever been a patient waiting—days, sometimes more than a week—for treatment approval, or a clinician stuck chasing it, you know what prior authorization feels like. Patients sit in limbo, ...

UnitedHealth Group and Cigna are revamping their prior authorization processes as new federal regulations aiming to ease the burden on providers and patients loom. UnitedHealthcare will eliminate ...

Centers for Medicare and Medicaid Services put forth a new set of rules to curb private insurance's use of prior authorization. These new rules will go into effect in 2026 and will impact care for the ...

Develop Health, an AI-powered eligibility and prior authorization automation platform, today announced its integration with athenaOne, bringing its end-to-end access automation directly into ...

The nation’s major health insurers are promising to scale back and improve a widely despised practice that leads to care delays and complications. UnitedHealthcare, CVS Health's Aetna and dozens of ...

U.S. Health and Human Services Secretary Robert F. Kennedy, Jr. and Centers for Medicare & Medicaid Services Administrator Dr. Mehmet Oz met with industry leaders to discuss their pledge to streamline ...

WASHINGTON — Health and Human Services Secretary Robert F. Kennedy Jr. said Monday that the country’s largest health insurers have promised to take steps to streamline the often-criticized prior ...

Prior authorization creates a bottleneck. A physician prescribes a patient a medication, the patient goes to the pharmacy to pick it up, only to be denied. The pharmacist calls the physician's office, ...

When your doctor decides you could benefit from a particular test or procedure, your insurance company might require documentation to prove it's necessary before agreeing to pay for anything.

"You mean, your doctor can prescribe something and then your insurance can just say I'm not covering that?" I glanced hopefully at the brochure a doctor at a study center handed me last year. They ...