New technology and frameworks have helped create new opportunities for hospitals to automate and control previously untouchable revenue cycle functions.

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

Objective: To evaluate the effectiveness of an automated prior authorization (PA) system (SmartPA) in reducing use of and expenditures for cyclooxygenase-2 (COX-2) inhibitors. Study Design: Before and ...

Strengthen your financial backup. Even with Medicare coverage, unexpected out-of-pocket expenses can pop up. Earn as much as ...

The requirement that physicians get prior authorization from insurers before providing a medical service, diagnostic test or medication may be the greatest single bottleneck for the delivery of ...

The new CMS regulations on prior authorization have been heralded as a big step forward in reducing administrative burdens on physicians, but some people think it doesn't go far enough. The CMS ...

If you or someone you know has experienced the frustration of a delayed medical procedure or a denied prescription due to prior authorization, you’re not alone. That’s why Indiana lawmakers are ...

Prior authorizations are hazardous to patients’ health, according to more than one-quarter of physicians. In a survey (PDF) by the American Medical Association, 28% of 1,000 responding physicians said ...

UnitedHealth Group Inc. plans to cut the number of procedures and medical devices requiring prior authorization, addressing a common complaint of health providers and patients and potentially speeding ...

In recent years, there has been a growing trend on the part of Medicare and Medicare Advantage plans to require prior authorization for a wide range of medical services. Though a physician or other ...

Federal lawmakers are pushing forward a bipartisan bill that would force some Medicare insurers to speed up their prior authorization decisions, but it may ultimately conflict with separate rules set ...