Why Prior Authorization Still Matters When you join a Medicare Advantage plan, your care sometimes requires an extra step ...

One physician is making the case that prior authorization for procedures should be reported to insurance plans as a CPT code—though that proposal has been withdrawn for now. Alex Shteynshlyuger, M.D., ...

The Centers for Medicare & Medicaid Services has released an operational guide for Medicare-enrolled providers and suppliers on the Wasteful and Inappropriate Service Reduction model.

PLANO, Texas, Aug. 20, 2025 /PRNewswire/ -- ZeOmega®, the leading population health management organization, today announced the launch of Smart Auth Optimizer, a machine learning-powered prior ...

Payer updates and policy changes delay reimbursement; Leaders say automated solutions can help fight back. The tug-of-war between providers and payers over prior authorizations is a consistent and ...

The new Medicare initiative would apply to claims for procedures such as steroid injections for pain management, electrical nerve stimulator implants, skin and tissue substitutes, devices for ...

Initially meant to protect patients from unnecessary procedures, prior authorizations have shifted towards being a cost containment strategy for health payers. This shift is causing significant ...

The Centers for Medicare and Medicaid Services (CMS) recently announced the launch of a program that will require individuals on Medicare to obtain prior approval from the federal health insurance ...

Health insurers covering more than 250 million Americans recently unveiled a sweeping plan to streamline and reduce prior authorization requirements — a pledge met with cautious optimism by revenue ...

Everyone’s talking about AI in healthcare — but in revenue cycle management, confusion remains about what it actually does. For RCM and finance leaders, the key question is: What makes an AI solution ...

The platform is giving physicians faith in quick prior authorization turnaround. Payer giant Humana has expanded its partnership with Cohere Health’s prior authorization platform for diagnostic ...

An AI-powered solution that automates prior authorizations from eligibility detection to appeals, helping health systems reduce admin burden, accelerate patient care, and prevent denials. Innovaccer ...