The Centers for Medicare & Medicaid Services (CMS) has been using prior authorization for selected Hospital Outpatient Department (OPD) services ...

The Centers for Medicare and Medicaid Services (CMS) has implemented prior authorization requirements for certain traditional ...

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 ...

Have you ever walked into the pharmacy and been told that your prescription requires a prior authorization? But your healthcare professional prescribed something for you, and you brought in your ...

The new KFF report found that payers either fully or partially denied 4.1 million prior authorization requests in 2024, or ...

Prior authorization has emerged as a flash point between payers and providers as the former tries to manage what they believe is waste in the system while the latter accuses payers of trying to deny ...

The paperwork burden of prior authorization keeps climbing, and for some ASCs, the only way through is to treat it like a daily fight. Elisa Auguste, administrator at East Setauket, N.Y.-based ...

It's no secret that burnout is a struggle across the healthcare industry, and the complex, time-consuming prior authorization process is one contributor. In fact, the U.S. Surgeon General addressed ...

A major pain point for physicians is also one—sometimes literally—for patients. In Texas, 25% of patients say insurers have refused to cover a medicine, procedure, test or scan that a doctor ordered ...