One physician is making the case that prior authorization for procedures should be reported to insurance plans as a CPT code—though that proposal has been withdrawn for now. Alex Shteynshlyuger, M.D., ...

Pitcher Mark Prior is attempting to resurrect his career in San Diego. "I understand the challenge and the road I’m facing," he said. ( (Jamie Squire/Getty Images) PEORIA, Ariz. – We are suckers for ...

Prior authorization has long been a sticking point between payers and providers, with payers arguing that it’s necessary to control costs and ensure that care is medically necessary and providers ...

The cost of prior authorization requirements on physician practices has continued to increase—up 60% in 2019 to manually generate a request to insurers. The just released CAQH 2019 Index, which ...

Payers have new deadlines to issue prior authorization decisions — 72 hours for urgent requests and seven days for non-urgent ones. Prior authorization is a process wherein a doctor must get approval ...

Forbes contributors publish independent expert analyses and insights. Jesse Pines is an expert in healthcare innovation and wellness. Health insurer prior authorization has increased considerably in ...

Insurers designate certain prescription drugs with prior authorization to ensure safe and medically appropriate use but also to contain costs. Here, a healthcare provider must obtain approval from a ...

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

Prior authorizations create substantial administrative and financial burdens on physicians and patients and can disrupt the continuity of care. This commentary discusses the current prior ...

A look at the rise of prior authorization certified specialists (PACS)—and their value in improving patient access and outcomes. The healthcare industry constantly grapples with the challenge of ...

Although companies should always report accurate information in their financial statements, this does not always happen, and sometimes the error is not caught until ...