Have you ever walked into the pharmacy and been told that your prescription requires a prior authorization? But your healthcare professional prescribed something for you, and you brought in your ...

Dr. Paola Ballester, a visionary physician-innovator and CEO of an AI-powered healthcare platform, joins the ...

Prior authorization is the process by which your doctor must request approval from your Medicare plan before they can order a particular medication or medical service. Generally, Original Medicare ...

Obtaining prior authorization for prescription medications is a time-consuming process for prescribers, patients and pharmacists that currently requires phone calls, faxes and hard-copy request forms.

The additional red tape could save money, but may harm patient access and quality of care. Stakeholders are urging the CMS to ...

In the Calendar Year 2020 Outpatient Prospective Payment System/Ambulatory Surgical Center Final Rule (2020 OPPS Final Rule), the Centers for Medicare and Medicaid Services (CMS) established a prior ...

Insurance companies often make doctors ask their permission before treating patients. This template can help medical ...

As congressional Democrats and Republicans battle over how to avert a potential government shutdown, another issue -- reining ...

The Biden administration released a proposal which, if finalized, would mandate Medicare Advantage (MA), Medicaid managed care, Affordable Care Act (ACA) plans and state Medicaid agencies implement ...

Already creating impact across top organizations like BioMatrix Specialty Infusion Pharmacy and Renown Health, Plenful's ...

The New Mexico Office of Superintendent of Insurance urges all health insurance consumers to actively monitor the status of any prior authorization requests submitted on their behalf. Prior ...

Please provide your email address to receive an email when new articles are posted on . Inefficiencies in prior authorization systems erode patient trust and can seriously impact care. Reform could ...