A bill intent on reforming the pre-authorization process in Delaware passed both chambers and is now under consideration from ...

Health insurer Humana is scaling back the number of medical services subject to prior approval and speeding up decisions ...

AI for prior authorization determinations in a recent survey. A Senate investigation shows they’re right to worry.

Stephanie Nixdorf's insurance company declined to cover a drug to treat her arthritis. That changed after she sent an appeal ...

With a baby on the way, Nathan Kirkland was facing a rare, aggressive form of bile duct cancer. Kirkland’s bills piled up as ...

Sundar Subramanian, a partner at PricewaterhouseCoopers (PwC) consulting affiliate Strategy&, has joined population health management company Zyter|TruCare as its newest CEO, Fierce Healthcare | AI ...

If you’re looking for further letter-writing guidance, the Patient Advocate Foundation’s Sample Appeal Letter for Denied Claim and Sample Appeal Letter for Pre-Authorization Denial may help.

Offering a rare glimpse inside the hidden world of rejected insurance claims, new data shows a steady uptick among major ...

CMS issued the 2026 Medicare Physician Fee Schedule, or PFS, proposed rule on July 14.It includes a 0.75% increase to the ...

A California addiction center found a way to compel Anthem to cover patients it rejected. Their dispute reflects a broader ...