More older Americans are challenging their Medicare Advantage plan's denial of a service, and it's paying off.

Health insurance companies make decisions on treatment but they aren't medical professionals. HB 434 would put decisions in ...

Will artificial intelligence finally streamline the cumbersome prior authorization process — or just add a new layer of ...

Health insurance companies are under increasing scrutiny for allegedly using artificial intelligence bots and algorithms to swiftly deny patients routine or lifesaving care— without a human actually ...

CMS Rule 0057 requires health plans to develop and support FHIR-based APIs to enable electronic prior authorization (ePA). Whether return on this investment stops at ...

Some forms of Humira may not be available ... If you have insurance, your insurance company may require prior authorization before it covers Humira. This means the company and your doctor will ...

HENRICO, Va. — Sheldon Ekirch spends a lot of time on hold with her health insurance company. This story also ran on CBS News. It can be republished for free. Do you have experience with prior ...

The insurance industry provides little information about how often prior authorization is used. Transparency requirements established by the federal government to shed light on the use of prior ...

The legislation created an Independent External Review organization that allows Pennsylvanians to submit an online form ... Pennsylvania Insurance Department overturned half of 517 denials, which ...

These delays frequently increase the costs of care and waste time for patients, providers and insurance plans themselves. Providers, for instance, spend an average of 12 hours per week handling prior ...

Prior authorization has become a pain point for patients and doctors. This is a KFF Health News story. Sheldon Ekirch spends a lot of time on hold with her health insurance company. Sometimes ...

HENRICO, Va. — Sheldon Ekirch spends a lot of time on hold with her health insurance company. Sometimes, as the minutes tick by and her frustration mounts, Ekirch, 30, opens a meditation app on ...