If a person’s Medicare plan requires prior authorization, their doctor will typically take responsibility for submitting the request. A person may need to complete certain forms beforehand.

Prior authorization specialists spend hours chasing down documentation, submitting forms and checking for updates. Billing teams reconcile denials long after the fact for consultative care ...

A bipartisan bill aiming to reform prior authorization has been reintroduced in the Senate. The Improving Seniors' Timely Access to Care Act seeks to streamline the prior auth process in Medicare ...

One survey found that 94% of physicians believe prior authorization leads to delays in care, while 89% say it has a negative impact on clinical outcomes. The simple truth is that the modern form ...

and still have medical complications because an insurance company denied the prior authorization claim.

Insurers initially denied 1.5% of dollars tied to claims because a prior authorization request was denied. That compared with a denial rate of 1.6% in 2023. The decline in rejections over prior ...

Cleveland-based MetroHealth has improved the speed and success of its medication prior authorization ... the provider that authorization is required, but now when the form populates, it’s ...

The bill calls for additional transparency in prior authorization determinations, and would also require that Medicare, Medicare Advantage and Medicare Part D plans make decisions based on medical ...

Ask a provider what’s causing tension in their relationship with insurers and many will point to prior authorization, arguing that the practice creates administrative burdens and delays in ...

AHN is the first health system to implement the fully automated, touchless prior authorization process, according to an April 28 news release. By entering a procedure order into the EHR ...

The bill would achieve those cuts in a variety of ways, including by introducing stricter enrollment and work requirements for the low-income and disabled Tennesseans who rely on TennCare ...