Andrew Mellin, M.D., discusses Surescripts’ pilot program for prior authorization system, which pulls clinical data from EHRs ...

Participating payers reported an 11% reduction in prior authorization requirements overall, with Medicare Advantage exceeding ...

Aligning electronic data submission requirements for prior authorizations is one prong of the insurance industry’s commitment ...

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 ...

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 ...

Use of prior authorization in the Medicare Advantage (MA) program continues to increase, according to a report from KFF. More than 46 million prior authorization requests were submitted to Medicare ...

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

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.

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 ...

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 ...

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 ...

The prior authorization process for patients with cancer demonstrates fewer days until submission and lower denial rates for Asian patients relative to White patients. Objective: Prior authorization ...