"Medically necessary" is often a four-letter word for patients.

Health plan executives expect AI to automate prior authorizations, improving turnaround times amid CMS regulatory changes, Deloitte finds.

Forbes contributors publish independent expert analyses and insights. Diane Omdahl is a Medicare expert who keeps her readers in the know. On June 27, 2025, the Centers for Medicare and Medicaid ...

Major health insurance providers have agreed to reduce the need for prior authorization — the requirement that patients must get approval from insurers before receiving certain treatments or risk ...

Some Medicare recipients are set to experience a new “prior authorization” measure as the Centers for Medicare & Medicaid Services (CMS) trials its much-discussed “Wasteful and Inappropriate Service ...

June 23 (UPI) --Major American insurers announced Monday that they have agreed to speed up and smooth out the processes involved with the reception and administration of health care by streamlining ...

Massachusetts regulators would eliminate many prior authorization rules, speed urgent approvals and form a working group to ...

R1 RCM has launched a new tool designed to automate and streamline the prior authorization process at scale. The tool, called R1 Prior Authorization, manages the full authorization lifecycle through a ...

A screen displays the logo and trading information for Humana on the floor of the NYSE in New York (Reuters) -Humana said on Tuesday it would eliminate about one-third of prior authorizations for ...

Powered by Phare Access – the smart patient access hub of R1’s Phare Operating System – R1 Prior Authorization manages the ...