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prior authorization for procedures should be reported to insurance plans as a CPT code—though that proposal has been withdrawn for now.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., ...

CMS recently announced a new model it will be using to pilot the use of artificial intelligence and machine learning in reviewing prior authorizations submitted for certain services CMS has identified ...

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.

The CMS will soon make it more difficult for providers in six states to get reimbursed in Medicare for certain medical procedures it has deemed “low value,” but some stakeholders worry it could lead ...

This story was originally published on Healthcare Dive. To receive daily news and insights, subscribe to our free daily Healthcare Dive newsletter. The CMS will test a new model beginning next year ...

Innovative new submission improvement -- available 24 hours a day, seven days a week -- provides nearly instant responses in most cases IRVINE, Calif.--(BUSINESS WIRE)-- Prescription Solutions, a ...

Cigna Healthcare, the health benefits provider of the Cigna Group, will be removing close to 25% of medical services from prior authorization requirements, the insurer said today. With the removal of ...

Wilmington, Del.-based AuthNet rolled out prior authorization and eligibility verification services for physicians, hospitals, ambulatory surgery centers and other medical facilities. AuthNet’s ...

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