If a person’s Medicare plan requires prior authorization, their doctor will typically take responsibility for submitting the request. A person may need to complete certain forms beforehand.

In health care, physicians are accountable for outcomes, patient access, satisfaction and costs. However, prior authorization ...

The current prior authorization process in U.S. healthcare constitutes a crisis, according to Jesse Ehrenfeld, immediate past ...

The health insurance industry counters that prior authorization and other forms of utilization management ... The Centers for Medicare and Medicaid Services instituted a rule in January that ...

Beneficiaries’ initial enrollment choices, whether active or passive, tend to have long-lasting implications because ...

Medical emergencies can happen at any time. Knowing what Medicare coverage you have, anywhere in the world, can help you ...

Healthcare has seen a slew of proposed policy changes at the federal level in recent months. Here are the 10 most important federal policy updates for ASC leaders and physicians to know since May 1: 1 ...

Ever felt like picking up your prescription was more complicated than booking a flight with three layovers? You’re not alone.

Prior authorization, a process requiring healthcare providers to obtain approval from insurance plans before certain medications, medical services, or procedures can be administered, is a significant ...

Community Hospital Corp. President and CEO Jim Kendrick says Medicaid reimbursement reductions could cripple rural ...

Congress has attempted to pass “federal PBM reform.” Members of Congress have held numerous hearings related to PBMs ...