Remember that physician who wanted to develop a Current Procedural Terminology (CPT) code for prior authorizations? It hasn't happened yet, but he hasn't given up on it, either. In May, Alex ...

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 ...

In an effort to soften the payer/provider relationship, many large health insurers are rolling back on prior authorizations. UnitedHealthcare (UHC) is the latest to cut back on its prior authorization ...

As care management and health IT continue their mutual evolution, payer organizations must negotiate complex requirements for processing authorization requests from their provider networks. Not only ...

Payer updates and policy changes delay reimbursement; Leaders say automated solutions can help fight back. The tug-of-war between providers and payers over prior authorizations is a consistent and ...

Top officials in the Department of Health and Human Services (HHS) are touting a multipronged effort from major payers to reform the oft-criticized prior authorization process. Mehmet Oz, M.D., ...

The Trump administration has promised to reduce the burden of prior authorizations, but experts say there is no easy solution. Prior authorizations, where insurers must approve certain medical ...

Few healthcare processes feel more entrenched than prior authorization — the insurer approval protocol that’s become shorthand for delays and red tape that complicates care and goodwill between ...

HCSC AI-enabled prior auth tool reduces claims submissions to 6 minutes Health Care Service Corporation is using augmented intelligence to accelerate prior authorization – up to 1,400 times faster – ...