Add Yahoo as a preferred source to see more of our stories on Google. Two pharmacy employees work behind the counter in a pharmacy, one on the phone and looking at a computer and the other writes on a ...

Prior authorization forces doctors to spend 13 hours a week fighting insurers. New federal rules are changing that. Here's what you need to know.

Obtaining prior authorization for prescription medications is a time-consuming process for prescribers, patients and pharmacists that currently requires phone calls, faxes and hard-copy request forms.

In the Calendar Year 2020 Outpatient Prospective Payment System/Ambulatory Surgical Center Final Rule (2020 OPPS Final Rule), the Centers for Medicare and Medicaid Services (CMS) established a prior ...

Prior authorization is a common utilization-management tool among Medicare Advantage plans. However, service-, area-, and carrier-level patterns suggest variation in how plans use prior authorization.

When Paula Chestnut needed hip replacement surgery last year, a pre-operative X-ray found irregularities in her chest. As a smoker for 40 years, Chestnut was at high risk for lung cancer. A specialist ...

Each prior auth transaction costs practices between $20 and $30 ...

Major U.S. health insurers, including UnitedHealthcare, Aetna, and Cigna, are advancing an industry-wide effort to standardize and reduce prior authorization requirements, aiming to speed care and cut ...

Have you ever walked into the pharmacy and been told that your prescription requires a prior authorization? But your healthcare professional prescribed something for you, and you brought in your ...