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

Bipartisan lawmakers have introduced a bill that aims to more closely align Medicare insurers’ prior authorization denials with medical need, as determined by board-certified specialist physicians.

Prior authorization has long been a source of frustration for healthcare providers, pharmacies, and patients, often delaying care and increasing costs. New electronic and automated solutions aim to ...

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Referrals and prior authorizations are key checkpoints in the healthcare system, but they can delay care if misunderstood or mishandled. While intended to ensure medical necessity and cost efficiency, ...

Prior authorization is no longer just a checkpoint in orthopedic care, It’s becoming a defining force in how, when and even whether patients receive treatment.  As payers expand algorithm-driven ...

LaTesha Harrison needs one or two scopes of her digestive system every year so her doctor can track her complications from Crohn’s disease. But the suburban Baltimore woman worries these necessary ...

Most medical groups have seen an increase in prior authorization requirements since last year, according to polling from the Medical Group Management Association. The association conducted the poll ...

Cigna is the latest health insurer to roll back prior authorization requirements, announcing Thursday that it will no longer require the approvals for nearly 25% of medical services. Cigna plans to ...