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

Between one-off charges, administrative fees, and office visit copays, some are trying ...

HHS finalizes HIPAA rule for electronic attachments to standardize claims and prior authorization, improving efficiency by 2027 compliance deadline.

Add Yahoo as a preferred source to see more of our stories on Google. Two pharmacy employees work behind the counter in a pharmacy, one on the phone and looking at a computer and the other writes on a ...

This episode, titled ‘Navigating Benefit Design and Utilization Management in ATTR-CM,’ features the experts examining how ...

Prior authorization is “wreaking havoc” on patient outcomes, physician burnout and productivity, a recent American Medical Association survey found. The survey was conducted in December and asked ...

Initially meant to protect patients from unnecessary procedures, prior authorizations have shifted towards being a cost containment strategy for health payers. This shift is causing significant ...

A group of major health care insurers, including Humana, whose CEO Bruce Broussard is pictured here, agred to streamline the prior authorizations process. File Photo by Oliver Contreras/UPI June 23 ...

Most providers say having the majority of their payers support the Prior Authorization API requirements is extremely ...

Remember that physician who wanted to develop a Current Procedural Terminology (CPT) code for prior authorizations? It hasn't happened yet, but he hasn't given up on it, either. In May, Alex ...

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 ...