The prior authorization bundles are for condition-specific procedures, Aetna said. Previously, providers had to submit two ...

A year ago, the killing of a health insurance executive on a Manhattan sidewalk unleashed many Americans’ pent-up frustration with insurers’ delays and denials of care.

A Medicare pilot program will allow private companies to use artificial intelligence to review older Americans' requests for ...

CVS Health’s Aetna health insurance unit said it will “integrate pharmacy prescriptions and medical procedures into a single ...

UnitedHealthcare, facing a storm of backlash from docs over its decision to implement a policy that would require prior authorization for some surveillance and diagnostic colonoscopies, is pushing ...

The idea behind it seems reasonable: Insurers want to ensure treatments are medically necessary before they pay for them. But ...

Strengthen your financial backup. Even with Medicare coverage, unexpected out-of-pocket expenses can pop up. Earn as much as ...

Electronic health record providers are starting work that could transform how nursing homes grapple with prior authorization requests and length of stay determinations.

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 ...

Initially meant to protect patients from unnecessary procedures, prior authorizations have shifted towards being a cost containment strategy for health payers. This shift is causing significant ...

In an effort to soften the payer/provider relationship, many large health insurers are rolling back on prior authorizations. UnitedHealthcare (UHC) is the latest to cut back on its prior authorization ...

The requirements will make exchanging health data more efficient and reduce administrative burden. Today CMS finalized the Interoperability and Prior Authorization Final Rule, continuing its efforts ...