In a country with higher healthcare costs, prior authorization can help insurers decrease expenses, potentially benefiting patients. For example, with Part D plans, prior authorization can ...

Ekirch said specialists have suggested that a series of infusions made from blood plasma called intravenous immunoglobulin — ...

The most familiar example is prior authorization, a process through which health plans verify a procedure, prescription or other clinical service will be covered by the patient's health plan ...

Insurance companies can change their prior authorization rules. For example, an insurer may choose to reduce the number of services, drugs, and devices that require a PA. By law, Medicare ...

Prior authorization is a method by which insurance ... Medical providers can recount endless examples of the PA system denying or delaying reasonable and needed care, testing and prescriptions ...

The price of an MRI, for example, can vary by hundreds to thousands of dollars within the same city for the same scan. The financial implications of limiting prior authorization are significant.

Laura Bobolts, PharmD, BCOP, senior vice president of clinical strategy and growth at OncoHealth, shares how health care leaders are advancing value-based care through improved data strategies, ...

Health insurance companies are under increasing scrutiny for allegedly using artificial intelligence bots and algorithms to swiftly deny patients routine or lifesaving care— without a human actually ...

Prior authorization requires doctors to get approval ... protect lucrative businesses from external reform. Optum Rx, for example, brought in $5.8 billion in profit last year, almost one-fifth ...

Sometimes a health insurer will require preauthorization of a medical procedure, and as a result may deny that pre-authorization, keeping the patient from getting the care they need, at least ...