A Massachusetts woman knew the medicine her doctor prescribed required preauthorization, but she didn’t realize the approval ...
Forbes contributors publish independent expert analyses and insights. Diane Omdahl is a Medicare expert who keeps her readers in the know. My 90-year-old uncle, a retired county employee, has had a ...
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 ...
Recently, we put together a template to help medical professionals explain a confusing process. Readers gave us very pointed feedback, so we updated it. By Ron Lieber Two months ago, I shared my tale ...
To combat growing criticism of prior authorization delays by payers, Centers for Medicare & Medicaid Services finalized a rule Wednesday that requires health plans to send prior authorization ...
Nearly seven months after the fatal shooting of an insurance CEO in New York drew widespread attention to health insurers’ practice of denying or delaying doctor-ordered care, the largest U.S.
California is one of 31 states that passed laws in 2025 limiting insurance companies’ use of prior authorization to approve or deny medical treatments.
Payers have new deadlines to issue prior authorization decisions — 72 hours for urgent requests and seven days for non-urgent ones. Prior authorization is a process wherein a doctor must get approval ...
Prior authorization — in which a patient needs approval from the health plan before proceeding with a medical service — has long created a rift between payers and providers. It has gotten such a bad ...
BRIDGEPORT, W.Va. — By the time Eric Tennant was diagnosed in 2023 with a rare cancer of the bile ducts, the disease had spread to his bones. He weighed 97 pounds and wasn’t expected to survive a year ...
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