Prior authorization has been a bone of contention between payers and providers for some time now. Payers argue that it helps avoid unnecessary care and reduces costs, while providers say it creates ...

Geisinger Health Plan and software company Cohere Health are teaming up to simplify the prior authorization process and reduce provider burden. Through the deal, Danville, Pennsylvania-based Geisinger ...

Staff at Arkansas' Harmony Park Family Medicine have been excited about streamlining the prior authorization process with the goal of improving patient access to high-quality care. Prior authorization ...

HCSC AI-enabled prior auth tool reduces claims submissions to 6 minutes Health Care Service Corporation is using augmented intelligence to accelerate prior authorization – up to 1,400 times faster – ...

In a future state, the automation of prior authorization decisions would be a natural element of high quality, value-based care. After all, the goal of prior authorization is to ensure that a member’s ...

Insurers large and small from across the country have announced a series of commitments they're making to reform one of the biggest pain points in the patient journey: prior authorization. Key steps ...

Prior authorizations are a critical part of the revenue cycle as they impact both reimbursement and patient access to care, and automation may help simplify the process. Many prior authorization ...

In 2025 alone, doctors and legislators across the country have already introduced more than 100 pieces of legislation meant to reform prior authorization. The cumbersome approval process is a leading ...

Health insurance exists to protect people, providing access to routine or potentially lifesaving care without breaking the bank. However, having insurance does not necessarily guarantee access or ...

Medicare Advantage rate cuts are coming next year, but prior-auth provisions slated for 2026 could tide palmier payer partnerships. CMS released finalized 2025 payment updates for the Medicare ...

Imagine you and your gastroenterologist have discussed a new ulcerative colitis (UC) treatment plan that promises to reduce your symptoms and the stress that comes with them. Then, when you go to ...