Denials for outpatient care claims jumped 16% in the last three years, while inpatient care claims rose 26%, according to a May 21 report from Kodiak Solutions. Kodak, which monitors patient financial ...

Humana has announced several steps it will take to ease prior authorization requirements. The insurer said Tuesday that by the start of next year, it will have fully eliminated about a third of prior ...

Of all the things that irritate physicians about health insurance, prior authorization might be at the top of the list. That didn’t stop the U.S. Centers for Medicare & Medicaid Service (CMS) from ...

Major health insurance providers have agreed to reduce the need for prior authorization — the requirement that patients must get approval from insurers before receiving certain treatments or risk ...

Beginning July 1, 2021, CMS will require prior authorization for cervical fusion with disc removal as well as implanted spinal neurostimulators. The strategy aims to ensure Medicare patients receive ...

OVERLAND PARK, Kan., July 09, 2020 (GLOBE NEWSWIRE) -- Beginning July 1, 2020, Medicare began requiring prior authorization for five types of surgery – blepharoplasty, botulinum toxin injections, ...

Many TRICARE members may confuse referral with authorization. A referral is when your primary care manager (PCM) or provider sends you to another provider for care. You may also need pre-approval, or ...

From Philly and the Pa. suburbs to South Jersey and Delaware, what would you like WHYY News to cover? Let us know! Here’s a common scenario: a patient visits their primary care doctor for lingering ...