As outpatient surgery continues its rapid migration from hospitals, a tension is emerging: the same payers pushing care into lower-cost settings are also making it harder to deliver it. From prior ...

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, ...

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 ...

Several health insurers are extending prior authorizations for elective services that have been canceled or deferred because of COVID-19. Blue Cross and Blue Shield of Minnesota shared with Becker’s ...

The government wants to save money by eliminating fraud and waste, but AARP and older adults are concerned the efforts block ...

Artificial intelligence will soon play a role in whether Medicare will pay for Ohioans' pain relief therapy and skin substitute bandages. Starting Jan. 1, technology will determine whether Medicare ...

UnitedHealth has rescinded a plan to require prior authorization for colonoscopies and other endoscopic procedures, following backlash from physician groups.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

2023 has been a tumultuous year when it comes to prior authorizations, as some payers have repealed major barriers to procedures, while others have added new rules. On Aug. 1, Humana rolled back prior ...

Six months after Eric Tennant died following a protracted battle with his health insurer over doctor-recommended cancer care, ...

AI’s role in insurance is already spawning lawsuits and battles over its regulation. That's not slowing down its use.

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 ...

Trina Paul is a Breaking News and Personal Finance Writer at Investopedia, covering topics like retirement, consumer debt, and retail investing. She focuses on making complex financial topics ...