The Centers for Medicare & Medicaid Services (CMS) has been using prior authorization for selected Hospital Outpatient Department (OPD) services ...

Administrative tasks burden today's physicians more than ever before. Obtaining prior authorizations for tests and treatments from payers is one of the leading productivity zappers, an activity which ...

When it comes to practice-management headaches, the hassle involved in obtaining prior authorizations from insurers often leads the list of complaints. And while many elements of fee-for-service ...

Surveyed medical groups reveal burdens have increased in the past 12 months, resulting in delays or denials for necessary care. Despite scrutiny of prior authorization practices in Medicare Advantage ...

Here’s how three ASC leaders are managing prior authorization: Note: Responses were lightly edited for style. Girard Bullaro, administrator at Wellness ASC (McKinney, Texas): As a new ASC and ...

When Paula Chestnut needed hip replacement surgery last year, a pre-operative X-ray found irregularities in her chest. As a smoker for 40 years, Chestnut was at high risk for lung cancer. A specialist ...

My colleagues and I recently tabulated how long psychiatric patients who were deemed in need of inpatient admission—overwhelmingly because of suicidal thoughts or plans—stayed in the emergency ...

Nearly 99% of Medicare Advantage patients are required to obtain prior authorization for certain services. KFF published an Aug. 8 report breaking down key statistics on Medicare Advantage patients ...

A prior authorization (or preauthorization) is an approval for a prescribed procedure, health care service or medication before you receive the care. If you're enrolled in a TRICARE Prime plan, your ...

While commercial insurers often use prior authorization as a way to control costs, it does the opposite for patients undergoing total hip arthroplasty, according to a study presented at the 2025 ...

While commercial insurers often use prior authorization as a way to control costs, it does the opposite for patients undergoing total hip arthroplasty, according to a study presented at the 2025 ...