Humana said on Tuesday it would eliminate about one-third of prior authorizations for outpatient services by next year, the ...

Humana disclosed Tuesday that it would stop requiring prior authorization for some healthcare services. The move comes just one day after it reopened a lawsuit contesting Centers for Medicare & ...

As ophthalmologists in Anchorage, we have witnessed the toll that delays in care have taken on patients and their families. That’s why we are proud to join our fellow physicians in celebrating the ...

Inappropriate denials for prior authorization and coverage of medically necessary services are a pervasive problem among certain plans in the Medicare Advantage (MA) program.

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

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

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

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.

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

Several insurers, such as UnitedHealthcare, Aetna and Cigna, pledged to improve prior authorization. These changes include streamlining decision timelines and increasing transparency.