Optum has launched a pair of AI-driven prior authorization products, one designed to speed up submissions on the provider side and another to accelerate clinical reviews for payers. The ...
The Centers for Medicare & Medicaid Services (CMS) has been using prior authorization for selected Hospital Outpatient Department (OPD) services ...
Optum is rolling out new AI-powered tools that aim to reduce delays associated with prior authorization. | Optum is rolling out new AI-powered tools that are aimed to reduce delays associated with ...
The pilot, launched in January 2026 in 6 states, could reduce wasteful spending, but increases provider paperwork and risks ...
Patients view prior authorization as the biggest burden in navigating the healthcare system, according to a new KFF poll. | Patients view prior authorization as the biggest burden in navigating the ...
Blue Shield is designing a centralized, machine-readable policy repository to enhance policy digitization and automation, speeding up prior authorization decisions. The organization has partnered with ...
A KFF survey published today found that people view prior authorization as the biggest challenge beyond costs when navigating the health care system. In terms of issues people viewed as a “major ...
The Centers for Medicare and Medicaid Services (CMS) has implemented prior authorization requirements for certain traditional ...
The paperwork burden of prior authorization keeps climbing, and for some ASCs, the only way through is to treat it like a daily fight. Elisa Auguste, administrator at East Setauket, N.Y.-based ...
"Medically necessary" is often a four-letter word for patients.
Depending on who you ask, prior authorization is a primary driver of administrative burden and delayed medical care or an essential tool for enhancing safety, improving health outcomes, and reducing ...
Effective Jan. 1, the Trump administration will, for the first time in the 60-year history of Medicare, implement a pilot project in six states (with Ohio being one of them) that will use private, for ...
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