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prior authorization


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publication date

Revenue Cycle
4 Stories Rev Cycle Leaders Are Following in 2023
Amanda Norris | September 28, 2023
From prior authorizations to coding, regulatory news ranked high in popularity for revenue cycle leaders this summer.
Revenue Cycle
First Wave of UHC Prior Auth Cuts Begin, But Will it Matter?
Amanda Norris | September 05, 2023
In an effort to soften the payer/provider relationship, many large health insurers are rolling back on prior authorizations.
Payer
Doctors and Patients Try to Shame Insurers Online to Reverse Prior Authorization Denials
KFF Health News | August 23, 2023
Insurers say the prior authorization helps them control costs.
Revenue Cycle
Medical, Insurer Groups Ask CMS to Not Implement Prior Authorization Provisions
Jay Asser | July 28, 2023
The organizations say the agency's proposed standards will be both conflicting and costly.
Payer
Medicaid Managed Care Has High Rates of Prior Authorization Denials
Jay Asser | July 21, 2023
A report by the Office of Inspector General (OIG) finds Medicaid managed care members may not be receiving all medically...
Revenue Cycle
Most-Read Revenue Cycle Articles in Q2 2023
Healthleaders | June 27, 2023
Check out the most-read revenue cycle articles from the past quarter.
Payer
Lawmakers Want Prior Authorization in Medicare Advantage Streamlined Even More
Jay Asser | June 23, 2023
The group are urging CMS to enhance its proposed rule and build on the regulations for the administrative process.
Clinical Care
Q&A With New American Medical Association President
Christopher Cheney | June 23, 2023
Jesse Ehrenfeld acknowledges there are many challenges in healthcare, but he is optimistic.
Payer
How Prior Authorization in Medicare Advantage is Harming Everyone
Jay Asser | June 07, 2023
Even for insurers, the administrative process in the private program has drawbacks that may not be worth the cost savings.
Revenue Cycle
Yet Another Payer Backtracks on Mandate Amid Provider Pushback
Amanda Norris | June 06, 2023
UHC is pulling back on its controversial prior authorization mandate.
Payer
Medicare Advantage in the Hot Seat: Challenges and Opportunities Part 2
Jay Asser | June 01, 2023
Payer
UHC's Alternative Proposal to Prior Authorization Policy Rejected by GI Docs
Jay Asser | May 31, 2023
The two sides remain apart as the payer's prior authorization mandate is set to begin on June 1.
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