The Centers for Medicare & Medicaid Services (CMS) has been using prior authorization for selected Hospital Outpatient Department (OPD) services ...

Your doctor submits a claim to your health insurance. The claim is denied. You might be justified in thinking the denial is ...

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 intelligent automation will deliver more timely decisions that reduce delays and improve access to care, Optum says.

The Centers for Medicare and Medicaid Services (CMS) has implemented prior authorization requirements for certain traditional ...

While the cost of health care remains the dominant worry among Americans, the process of obtaining prior authorization from ...

Abridge has teamed its AI platform for clinical conversations with Availity’s digital platform that connects payers and providers to enable payer determination during a patient visit. The ...

On January 14, 2026, Massachusetts Governor Maura Healey announced that the Division of Insurance (DOI) will be promulgating updates to ...

The CMS Final Rule signals a future in which prior authorization isn’t just faster but fairer. AI has the potential to accelerate decisions, lower administrative costs and support equitable access to ...

"Medically necessary" is often a four-letter word for patients.

Massachusetts insurance regulators unveiled sweeping prior authorization reforms that would scrap pre-approval requirements for "many routine and essential" health care services, Gov. Maura Healey ...

Alabama indefinitely suspends entire state-controlled Bessemer board of education ...