New AI-powered capability helps providers verify documentation and authorization readiness upfront, preventing denials ...

Dana Kelso Spradling says she's dealing with an insurance nightmare, after the medication she had already received a prior ...

The Office of Inspector General has released a report examining prior authorization patterns from seven managed care companies, and based on the findings is urging increased oversight of prior ...

In addition to concerns about AI, the survey revealed concerns about delays in care, health care costs, and physician burnout. Most physicians surveyed expressed concern that health insurance ...

"Medically necessary" is often a four-letter word for patients.

While the cost of health care remains the dominant worry among Americans, the process of obtaining prior authorization from ...

Long-running efforts to limit health plans' ability to deny or delay physician-ordered care are on hold again, despite ...

Nearly 53 million prior authorization requests were sent to insurers in 2024, compared with nearly 50 million in the prior year, according to KFF. Almost 8% of those requests were partially or fully ...

Does Medicare require prior authorization? Medicare Advantage plans often require prior authorization. But these coverage reviews are rare for original Medicare. That distinction changes in 2026. Many ...

Medicare Advantage plans have been changing the last few years, and more changes seem likely for 2027. There also are some changes many people want that might not occur.

Depending on your health insurance policy, you may have noticed that you need to get permission from your insurer before it will pay for a medication, treatment or procedure your doctor prescribes — ...

When Sally Nix found out that her health insurance company wouldn’t pay for an expensive, doctor-recommended treatment to ease her neurological pain, she prepared for battle. It took years, a chain of ...