Prior authorizations stand as both a gatekeeper and a stumbling block for the ASC industry. These pre-approvals required by payers serve as a crucial step in ensuring the medical necessity of ...

Administrative tasks burden today's physicians more than ever before. Obtaining prior authorizations for tests and treatments from payers is one of the leading productivity zappers, an activity which ...

My colleagues and I recently tabulated how long psychiatric patients who were deemed in need of inpatient admission—overwhelmingly because of suicidal thoughts or plans—stayed in the emergency ...

When it comes to practice-management headaches, the hassle involved in obtaining prior authorizations from insurers often leads the list of complaints. And while many elements of fee-for-service ...

Prior authorization is the process by which your doctor must request approval from your Medicare plan before they can order a particular medication or medical service. Generally, Original Medicare ...

Surveyed medical groups reveal burdens have increased in the past 12 months, resulting in delays or denials for necessary care. Despite scrutiny of prior authorization practices in Medicare Advantage ...

Recipients of Medicaid frequently face prior authorization hurdles when pursuing medical care or treatment. Medicaid is a ...

While commercial insurers often use prior authorization as a way to control costs, it does the opposite for patients undergoing total hip arthroplasty, according to a study presented at the 2025 ...

Please provide your email address to receive an email when new articles are posted on . UnitedHealthcare recently announced that beginning June 1, 2023, commercial plan members will be required to ...

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 ...