Annual report details prior authorization automation work with Fairview Health Services, Cleveland Clinic and Optum Rx ...

PAIR Benchmark scores overall readiness at 58/100, with ~35-40% provider-side manual fallback and only ~20% reporting SLO-grade monitoring and runbooks. LAS VEGAS, NEVADA / ACCESS Newswire / March 3, ...

Surescripts®, the nation’s leading health intelligence network, today released its Annual Impact Report 2025, highlighting record advancements in health data interoperability, enhanced efficiency for ...

Prior Authorization for Traditional Medicare Patients Has Started in 6 States The Centers for Medicare and Medicaid Services (CMS) has implemented prior authorization requirements for certain ...

Semaglutide (GLP-1) drugs like Ozempic are designed to treat type 2 diabetes, but are widely known for their effect on weight loss. Credit: Shahrzad Rasekh / CT Mirror Groups representing low-income ...

This article highlights challenges in prior authorization and offers practical, experience-based strategies to streamline workflows, reduce delays, and improve patient access to necessary treatments.

Some medical procedures and treatments require prior authorization from your health insurance company, meaning you'll need pre-approval before you can receive care. This episode, health care reporter ...

The Centers for Medicare & Medicaid Services (CMS) has been using prior authorization for selected Hospital Outpatient Department (OPD) services for several years as part of its broader effort to curb ...

Blue Shield is designing a centralized, machine-readable policy repository to enhance policy digitization and automation, speeding up prior authorization decisions. The organization has partnered with ...

Nearly all MA enrollees are subject to prior authorization — where providers have to receive an insurers’ approval before offering a service or medication — for some types of care, according to the ...

Settling into 2026, prior authorization continues to be a contentious topic for payers, providers, lawmakers and other leaders. From piloting prior authorization in Medicare to governors pitching ...