prior authorization
publication date
Infographic: Making the AHIP Prior Auth Pledge Matter
Beyond voluntary promises, standards and a federal mandate for FHIR-based APIs create a powerful framework for real prior authorization reform...
Revenue Cycle
Infographic: CMS Tests New PA Requirements in Traditional Medicare
In a pilot program set to begin in 2026, CMS will test new prior authorization requirements for 17 services in...
Revenue Cycle
NCQA Says Payer PA Pact is a 'Promising Step'
While revenue cycle executives are skeptical of the voluntary pact between payers to reform prior authorization, the NCQA?s VP of...
Revenue Cycle
HL Shorts: The Foundation-First Approach to Prior Authorization
There's a lot of hype around the potential for new technologies to fix the prior authorization process, but this rev...
Revenue Cycle
Infographic: Top 6 Rev Cycle Stories of 2025 (So Far)
From the relentless rise of claim denials to major policy debates around prior authorization and the 340B program, the first...
Revenue Cycle
Infographic: A New Pact on Prior Auth
More than 40 payers have voluntarily signed onto to pact to transform prior authorization processes. Here is a breakdown of...
Revenue Cycle
CMS to Test New Prior Authorization Requirements in Traditional Medicare
A new CMS model will introduce new prior authorization requirements to traditional Medicare in six states, raising provider concerns about...
Revenue Cycle
HL Shorts: Northwell Health Exec Talks Top Prior Authorization Headaches
Inconsistent payer rules are a major pain point for revenue cycles with direct clinical and financial impact on patients, according...
Payer
5 Takeaways from Health Insurers' New Pledge to Improve Prior Authorization
Trump administration officials applauded the insurance industry for its willingness to change, but also acknowledged limitations of the agreement.
Revenue Cycle
Rev Cycle Leaders Cautiously Optimistic Over AHIP Plan to Limit Prior Authorization
More than 40 payers have voluntarily committed to significant prior authorization reforms, but will this time be any different?
CFO
Live From HFMA: 3 Takeaways for CFOs (So Far)
At HFMA, themes of payer collaboration, operational leadership, and smarter investments are dominating the conversation.
Revenue Cycle
Infographic: 4 Quick Quotes from the April Rev Cycle NOW Summit
See what revenue cycle leaders had to say during the April 2025 Revenue Cycle NOW Online Summit, a 2-part webinar...