Forbes contributors publish independent expert analyses and insights. Jesse Pines is an expert in healthcare innovation and wellness. Health insurer prior authorization has increased considerably in ...
Prior authorization has long been a sticking point between payers and providers, with payers arguing that it’s necessary to control costs and ensure that care is medically necessary and providers ...
Insurers designate certain prescription drugs with prior authorization to ensure safe and medically appropriate use but also to contain costs. Here, a healthcare provider must obtain approval from a ...
The Centers for Medicare and Medicaid Services finalized the CMS Interoperability and Prior Authorization Rule on Wednesday. CMS said the rule will improve the prior authorization process and save ...
Prior authorizations create substantial administrative and financial burdens on physicians and patients and can disrupt the continuity of care. This commentary discusses the current prior ...
A year ago, the fatal shooting of a health insurance executive on a Manhattan sidewalk unleashed many Americans’ pent-up frustration with insurers’ delays and denials of care. UnitedHealthcare CEO ...
Medicare Advantage plans say it reduces waste and inappropriate care. Critics say it often restricts coverage unnecessarily. By Paula Span Slowly but steadily, Marlene Nathanson was recovering. She ...
Under a final rule released today, impacted payers will be required to send prior authorization decisions within 72 hours for urgent requests and seven calendar days for standard requests. The Centers ...
Editor’s Note: This story was published last year, before the murder of UnitedHealthcare’s chief executive, which is drawing renewed attention to how the insurance industry denies care to patients.
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