Nearly all those who have Medicare Advantage plans must deal with prior authorization. Now more prior authorization issues are appearing with Part D prescription drugs.

Technology hurdles, particularly lack of standardization and interoperability, often hinder the prior authorization process. Robust communication strategies can address those problems.

Rep. Dr. Greg Murphy (R-N.C.) hopes his personal ordeal with prior authorizations will help inspire Congress to act.

Beginning in 2014, the Centers for Medicare & Medicaid Services (CMS) has permitted Medicare Advantage insurers to offer ...

By simply entering an order for a procedure into an electronic health record (EHR), AHN can now receive prior authorization from payers without any other human intervention, thanks to Humata’s ...

But in October, his Humana Medicare Advantage plan — an alternative ... thing for us is the fact that coverage denials and prior authorization delays impact the care a patient receives, and ...

According to the KFF’s report of 2024 Medicare Advantage plans, 36% of individual plans and 88% of Special Needs Plans (SNPs) included some form of transport coverage. As private insurers ...

If a person has diabetes, Medicare covers one annual eye exam for diabetic retinopathy. This exam must be performed by a doctor or healthcare professional who is legally allowed to conduct it in ...

Legislation focused on prior authorization reforms is headed to the governor after Senate lawmakers approved changes to the bill Wednesday. Lawmakers said the bill is an important step in ...

(Brandon Smith/IPB News) Legislation focused on prior authorization reforms is headed to the governor after Senate lawmakers approved changes to the bill Wednesday. Lawmakers said the bill is an ...