The idea behind it seems reasonable: Insurers want to ensure treatments are medically necessary before they pay for them. But in practice, it often means delayed appointments, stalled medication ...

Starting Jan. 1, traditional Medicare recipients in Washington state will face a new hurdle to get certain procedures covered — private AI companies that get paid based on how many claims they deny.

The medical billing process can be complicated. Follow this step-by-step process to ensure you do it correctly.

The start of the legislative session is just around the corner. Beginning in December, the Missouri Senate allows senators to ...

More than 50 major insurers have pledged to streamline prior authorization starting in 2026, but providers remain cautiously optimistic and skeptical that the changes will truly reduce burden or ...

A year ago, the fatal shooting of a health insurance executive on a Manhattan sidewalk unleashed many Americans’ pent-up frustration with insurers’ delays and denials of care. UnitedHealthcare CEO ...

St. Peter’s Healthcare System prepared its staff and processes for the new Medicare prior authorization pilot starting January ...

Artificial intelligence will soon be used for prior authorization for certain Medicare services in Texas and five other ...

Discover how the HIPAA Waiver of Authorization permits legal sharing of health data for research while upholding privacy protections. Learn the criteria required for approval.

Over half of seniors will need help with eating, getting dressed or other basic activities at some point, according to the U.S. Department of Health and Human Services, and the cost of help continues ...