Add Yahoo as a preferred source to see more of our stories on Google. In June of this year, CMS announced that it would be launching the Wasteful and Inappropriate Service Reduction (WISeR) Model, ...

Wash., found procedures in the state that were previously approved within around two weeks now take four to eight weeks to be ...

Sen. Cantwell urges HHS Secretary RFK Jr. to reform CMS’s AI prior authorization program amid care delays and provider burdens.

One physician is making the case that prior authorization for procedures should be reported to insurance plans as a CPT code—though that proposal has been withdrawn for now. Alex Shteynshlyuger, M.D., ...

The healthcare industry is on the brink of a transformative shift in the way prior authorizations are managed. Traditionally, prior authorizations have relied heavily on an attestation model, where ...

Senator Maria Cantwell has called on HHS to overhaul the Wasteful and Inappropriate Service Reduction (WISeR) Model.

UnitedHealthcare announced it will include over 70% of its prior authorization volume in a new standardized electronic submission process by the end of 2026. The initiative, spanning commercial, ...

Prior authorization delays and denials often stem from incomplete or mismatched ICD-10 coding and documentation. By aligning diagnosis codes precisely with procedures and payer rules, providers can ...

Early hospital data highlighted on Capitol Hill suggest that Medicare patients are waiting substantially longer to receive ...

Many health systems and patients have struggled with prior authorization procedures. Prior authorization practices are staying in the spotlight. Health systems are looking for payers to do more to ...

Many physicians and practices say prior authorization is a major administrative burden and have urged lawmakers to institute reforms to the process for commercial and public payers. Nearly 97% of ...

UnitedHealth has rescinded a plan to require prior authorization for colonoscopies and other endoscopic procedures, following backlash from physician groups. UnitedHealth, which operates the biggest ...