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

UnitedHealthcare pares back prior authorizations and speeds payments for 1,500 rural hospitals, expanding nationwide by fall 2024.

With CMS expanding its infrastructure for pre-payment review in traditional Medicare, here are five things practice leaders ...

This article highlights challenges in prior authorization and offers practical, experience-based strategies to streamline workflows, reduce delays, and improve patient access to necessary treatments.

Prior authorization is a common utilization-management tool among Medicare Advantage plans. However, service-, area-, and carrier-level patterns suggest variation in how plans use prior authorization.

Prior authorization is becoming stricter in 2026, with tighter documentation requirements, faster denial algorithms, and new federal ePA standards. Providers must adapt with precise ICD-10 coding, ...

Dozens of health insurers have made a series of commitments to improve and reduce prior authorization, payer advocacy organization AHIP announced on Monday. The practice is often a point of contention ...

Physicians surveyed by the AMA say that PA can cause care delays or force patients to abandon treatment. They warn denials could increase as insurers adopt AI to review claims. Physicians have long ...

New Year’s Day, the day of new beginnings, is a day health care providers like me dread. It starts the annual deluge of requests to renew “prior authorizations” — a bureaucratic tactic that insurers ...