For decades, Original Medicare (sometimes called traditional Medicare) has been known for its simplicity. Beneficiaries ...

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

The Wasteful and Inappropriate Service Reduction initiative from CMS is set to take effect Jan. 1, 2026, introducing new prior authorization requirements for select services. Here are seven things to ...

When you are sick or in pain, the prior authorization process can be frustrating and will sometimes result in a denial. If you've never been through the process, prior authorization is a requirement ...

GoodRx reports that starting January 2026, original Medicare will require prior authorization for certain services in six ...

Navigating the healthcare system can be a complex and frustrating experience for many patients. Among the many challenges, one of the most insidious barriers to timely care is prior authorization.

While there's a lot of buzz around prior authorization, it applies to fewer than 2% of claims. Prior authorization ensures care is both safe and aligned with the most up-to-date clinical guidelines.

Prior authorization can be a pain point for spine surgeons getting reimbursement approved by CMS and insurers, but artificial intelligence holds potential for improving that process for providers, ...

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 ...

Tenet prepared for Medicare prior authorization pilot launching in six states in 2026, focusing on compliance and ...

If you’ve ever been a patient waiting—days, sometimes more than a week—for treatment approval, or a clinician stuck chasing it, you know what prior authorization feels like. Patients sit in limbo, ...

Few readers would be surprised to read that Americans are dissatisfied with their health care coverage — an outrage that the December 2024 assassination of UnitedHealthcare CEO Brian Thompson arguably ...