Prior authorization can help encourage the efficient use of health care resources but too often, it delays treatment patients ...
The aggravating prior authorization process includes one step that merits scrutiny and potentially regulatory action: the ...
The new CMS regulations on prior authorization have been heralded as a big step forward in reducing administrative burdens on physicians, but some people think it doesn't go far enough. The CMS ...
The requirement that physicians get prior authorization from insurers before providing a medical service, diagnostic test or medication may be the greatest single bottleneck for the delivery of ...
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 ...
New technology and frameworks have helped create new opportunities for hospitals to automate and control previously ...
Prior authorizations are hazardous to patients’ health, according to more than one-quarter of physicians. In a survey (PDF) by the American Medical Association, 28% of 1,000 responding physicians said ...
Objective: To evaluate the effectiveness of an automated prior authorization (PA) system (SmartPA) in reducing use of and expenditures for cyclooxygenase-2 (COX-2) inhibitors. Study Design: Before and ...
The following information was released by the Ohio State Medical Association:. There has been a huge amount of legislative activity over the past two weeks on OSMA-supported insurance reform proposals ...
Doctors say that the process too often leads to delays in patient care and sometimes causes consumers to abandon treatment. Beginning in June 2023, health plans in Michigan will have to act on ...
A report by the Office of Inspector General (OIG) finds Medicaid managed care members may not be receiving all medically necessary services. Medicaid managed care organizations (MCOs) denied one out ...
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Understanding Medicare Advantage Prior Authorization
Why Prior Authorization Still Matters When you join a Medicare Advantage plan, your care sometimes requires an extra step ...
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