Preauthorization is about to enter the lives of many seniors who have chosen traditional Medicare over MA, write former CMS ...

The bill sets new requirements for insurers, including stricter timelines for decisions and appeals, and mandates ... District of Columbia have passed prior authorization reform legislation, according ...

And yet, KFF says, more than 4 in 5 (83.2%) of such appeals that are made succeed in overturning the denial, at least partially. Which is to say, it’s worth trying. If you’re denied a prior ...

A 2024 report from KFF found Medicare Advantage insurers fully or partially denied 7.4% (3.4 million) of claims submitted for health care pre-authorization in 2022, a sharp jump up from 5.8% in ...

Consistent with prior arguments that administrative burden is a mechanism of inequality, I found in my survey that less affluent patients are less likely to appeal coverage denials, as are those ...

I was diagnosed with osteopenia, or low bone mineral density, at an unusually young age. Shortly after my initial diagnosis, my condition progressed into full blown osteoporosis. Unfortunately, the… ...