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

The Centers for Medicare & Medicaid Services has finalized its prior authorization rule – and insurers have to provide a specific reason for denying an urgent medical service request, as well as ...

CMS is not proposing payers must use implementation guides for the installation of APIs, which was a requirement in the 2020 rule. The agency conceded that while the guides will “play a critical ...

Last year, only 26% of the provider groups UnitedHealthcare works with submitted more than one prior authorization request, Docimo said. "It may be perceived as prevalent, but it's not required in ...

UnitedHealthcare recently announced that beginning June 1, 2023, commercial plan members will be required to obtain prior authorization for gastroenterology endoscopy services. By far the largest ...

Prior authorization, when done right with true peer-to-peer conversations, can be good for doctors and their patients. ... To submit a correction request, please visit our Contact Us page.

Dive Brief: Cigna is the latest health insurer to roll back prior authorization requirements, announcing Thursday that it will no longer require the approvals for nearly 25% of medical services.

A KFF study found that Medicare Advantage plans issued more than 35 million prior authorization requests in 2021. More than 2 million of these requests were fully or partially denied.