Please provide your email address to receive an email when new articles are posted on . Overall, 81.3% of patients whose care was initially denied had the claim reversed to eventually have spine ...

CMS is launching a five-year Prior Authorization Demonstration for certain ambulatory surgical center (ASC) services beginning December 15, 2025, in 10 states, including Georgia, Florida, Tennessee, ...

A policy aiming to save Medicare money has not had the intended effect on outpatient surgery. As the policy expands across the country, researching the results of this policy could inform how ...

UnitedHealth Group and CVS Health have standardized data and submission rules for more than half of their prior ...

NEW ORLEANS, March 2, 2026 /PRNewswire/ -- As public and private health plans seek to reduce rising medical costs, requiring prior authorization (PA) for high-cost procedures has become standard. A ...

Payers must continue to assess their prior authorization practices to uphold the goals of clinical quality, safety, and utilization management. Like many others, I was drawn to be a doctor because I ...

Prior authorization delays and standardized codes that do not measure case variability are just two orthopedic policy disconnects surgeons say they face on a day-to-day basis. While insurance ...

SPRINGFIELD, Mo. (KY3) - Prior authorizations are standard this time of year as insurance changes. They’re essentially a request from your insurance asking for more information before agreeing to ...

In this week’s edition of InnovationRx, we look at efforts to improve prior authorization, commercializing Bell Labs’ IP portfolio, a new billionaire from Caris Life Sciences’ IPO, a big funding round ...

For the most part, Keyanna Jones and her husband thought they knew what to expect when their daughter Chloë had eye surgery last fall. Even Chloë, who was in kindergarten, had a good understanding of ...

A new policy increased wait time for patients, but didn't speed up the move from hospital-based to outpatient-based operations. A new policy increased wait time for patients, but didn’t speed up the ...