Forbes contributors publish independent expert analyses and insights. Jesse Pines is an expert in healthcare innovation and wellness. This voice experience is generated by AI. Learn more. This voice ...

This article highlights challenges in prior authorization and offers practical, experience-based strategies to streamline workflows, reduce delays, and improve patient access to necessary treatments.

Under a final rule released today, impacted payers will be required to send prior authorization decisions within 72 hours for urgent requests and seven calendar days for standard requests. The Centers ...

Insurance companies often make doctors ask their permission before treating patients. This template can help medical professionals explain how it works. By Ron Lieber Ron Lieber will update this ...

Ramya Ganti is the founder and CEO of Oprox, a VC-backed AI-native revenue intelligence platform for healthcare providers.

Jaclyn Mayo has multiple sclerosis, an autoimmune disease that damages the nervous system and can mess with coordination and balance. To get steadier on her feet, Mayo had been trying to lose weight: ...

New Year’s Day, the day of new beginnings, is a day health care providers like me dread. It starts the annual deluge of requests to renew “prior authorizations” — a bureaucratic tactic that insurers ...

Prior authorization is a common utilization-management tool among Medicare Advantage plans. However, service-, area-, and carrier-level patterns suggest variation in how plans use prior authorization.