Each prior auth transaction costs practices between $20 and $30 ...

Medicaid Managed Care Organizations (MCOs) denied one out of eight prior authorization requests in 2019, according to a new report from the Office of Inspector General (OIG). The OIG review included ...

The need to fix healthcare’s antiquated prior authorization (PA) process remains a hot-button issue in the industry, garnering policy attention and spurring the development of myriad technology ...

The new CMS regulations on prior authorization have been heralded as a big step forward in reducing administrative burdens on physicians, but some people think it doesn't go far enough. The CMS ...

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 ...

Use of prior authorization in the Medicare Advantage (MA) program continues to increase, according to a report from KFF. More than 46 million prior authorization requests were submitted to Medicare ...

In 2026, the Centers for Medicare and Medicaid Services (CMS) will expand prior authorization in the fee-for-service program through the Wasteful and Inappropriate Service Reduction (WISeR) Model.

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 ...

Payers must continue to assess their prior authorization practices to uphold the goals of clinical quality, safety, and utilization management. Like many others, I was drawn to be a doctor because I ...

Please provide your email address to receive an email when new articles are posted on . Physicians reported that prior authorizations diverted time, increased health care utilization and delayed care.

Forbes contributors publish independent expert analyses and insights. Bruce Japsen writes about healthcare business and policy. This article is more than 2 years old. The American Medical Association, ...

It took 13 years of training and education for me to earn a license to practice medicine and perform surgery on the eye. For more than 30 years since, I’ve been attempting to provide the best there is ...