prior authorization

Each year millions of patients continue to face denials through the prior authorization process.

While The CMS Interoperability and Prior Authorization Final Rule promises to streamline prior authorizations and increase payer accountability, will providers...

Health systems and hospitals spent more than $1 billion on the technology in 2025, with ambient AI and coding/billing programs...

From the possible rise of agentic AI to the potential for payer cooperation on prior authorization, we look at five...

From the denials to critical updates on 340B and prior authorization, here is a look back at the trends and...

For select conditions, Aetna is introducing processes for authorizations that integrate pharmacy prescriptions and medical procedures into a single clinical...

A tiny tick bite exposes how prior authorization can apply to inexpensive and medically necessary treatments.

While the AHA has called on CMS to rethink its plan to add prior authorization requirements to traditional Medicare, some...

The integrated health system has a grand vision to use conversational AI as an 'added member of the care team'...

Christine Migliaro of Northwell Health offers a reality check on prior auth automation, detailing the challenges from ROI and user...

The pilot program, designed to weed out wasteful, 'low-value' services, expansion the federal use of prior authorization.

Beyond voluntary promises, standards and a federal mandate for FHIR-based APIs create a powerful framework for real prior authorization reform...