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

Prior authorization has been a bone of contention between payers and providers for some time now. Payers argue that it helps avoid unnecessary care and reduces costs, while providers say it creates ...

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 ...

Natalie Tate, PharmD, is vice president of pharmacy at BlueCross BlueShield of Tennessee. Nationwide, prescription drugs are the costliest and commonly used heath plan benefit. Last year, BlueCross ...

The prior authorization process continues to have a "devastating" effect on patient outcomes, physician burnout and employee productivity, according to a new physician survey from the American Medical ...

Forbes contributors publish independent expert analyses and insights. Richard Menger is a neurosurgeon and a political scientist. You have worked for your company for 15 years. You suffer from chronic ...

Please provide your email address to receive an email when new articles are posted on . Most medications in allergy and asthma care require prior authorization. Providers should screen for failed ...

Earlier this year, the Centers for Medicare & Medicaid Services (CMS) announced an agreement with Medicare Advantage plans to lessen the use of prior authorization, but the agency also said it would ...

Prior authorization companies are moving into ambient listening, while ambient listening companies are expanding into prior authorization — a trend underscored by yet another partnership bridging the ...

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 ...

Please provide your email address to receive an email when new articles are posted on . Physicians reported that prior authorizations diverted time, increased health care utilization and delayed care.

Surescripts®, the nation's leading health intelligence network, today announced a major expansion of its Touchless Prior Authorization technology, now reaching more than 76,000 prescribers across the ...