Dana Kelso Spradling says she's dealing with an insurance nightmare, after the medication she had already received a prior ...

California is one of 31 states that passed laws in 2025 limiting insurance companies’ use of prior authorization to approve ...

The intelligent automation will deliver more timely decisions that reduce delays and improve access to care, Optum says.

While the cost of health care remains the dominant worry among Americans, the process of obtaining prior authorization from ...

New Medicaid prior-authorization rules have advocates in Connecticut concerned about patients losing access to their ...

The Centers for Medicare and Medicaid Services (CMS) has implemented prior authorization requirements for certain traditional fee-for-service Medicare services in six states starting this year. Here ...

Prior authorization is no longer just an administrative hurdle for ASCs; it is a defining constraint on growth. As authorization requirements expand, policies shift and payer scrutiny intensifies, ...

Physicians surveyed by the AMA say that PA can cause care delays or force patients to abandon treatment. They warn denials could increase as insurers adopt AI to review claims. Physicians have long ...

Payers have new deadlines to issue prior authorization decisions — 72 hours for urgent requests and seven days for non-urgent ones. Prior authorization is a process wherein a doctor must get approval ...

Nearly 53 million prior authorization requests were sent to insurers in 2024, compared with nearly 50 million in the prior year, according to KFF. Almost 8% of those requests were partially or fully ...