More than 50 major insurers have pledged to streamline prior authorization starting in 2026, but providers remain cautiously optimistic and skeptical that the changes will truly reduce burden or ...

The idea behind it seems reasonable: Insurers want to ensure treatments are medically necessary before they pay for them. But in practice, it often means delayed appointments, stalled medication ...

A year ago, the killing of a health insurance executive on a Manhattan sidewalk unleashed many Americans’ pent-up frustration with insurers’ delays and denials of care.

When Paula Chestnut needed hip replacement surgery last year, a pre-operative X-ray found irregularities in her chest. As a smoker for 40 years, Chestnut was at high risk for lung cancer. A specialist ...

The start of the legislative session is just around the corner. Beginning in December, the Missouri Senate allows senators to ...

The nation’s major health insurers are promising to scale back and improve a widely despised practice that leads to care delays and complications.UnitedHealthcare, CVS Health's Aetna and dozens of ...

Artificial intelligence will soon be used for prior authorization for certain Medicare services in Texas and five other ...

Prior authorization — in which a patient needs approval from the health plan before proceeding with a medical service — has long created a rift between payers and providers. It has gotten such a bad ...

Writer questions using private, for-profit companies' artificial intelligence and wonders about a conflict of interest in Medicare's WISeR pilot.

Health plans have been expanding the use of prior authorization as a tool to control costs for several years, to the frustration of physicians. MGMA members put the practice at the top of a list of ...

Develop Health, an AI-powered eligibility and prior authorization automation platform, today announced its integration with athenaOne, bringing its end-to-end access automation directly into ...