Although companies should always report accurate information in their financial statements, this does not always happen, and sometimes the error is not caught until ...

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 ...

A look at the rise of prior authorization certified specialists (PACS)—and their value in improving patient access and outcomes. The healthcare industry constantly grapples with the challenge of ...

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 ...

Few healthcare processes feel more entrenched than prior authorization — the insurer approval protocol that’s become shorthand for delays and red tape that complicates care and goodwill between ...

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.

It’s another busy day in my spine surgery clinic when my phone rings. Patients are waiting, but I’d be unwise to put off the caller: a physician calling from a health insurance company. This ...

For decades, Americans have endured a healthcare system where access to care is delayed not by clinical need, but by administrative demands with little benefit. Prior authorization, the process ...

New Year’s Day, the day of new beginnings, is a day health care providers like me dread. It starts the annual deluge of requests to renew “prior authorizations” — a bureaucratic tactic that insurers ...