prior authorization
publication date
CFO
Yay for MA? System CFOs Bitter-Sweet on New CMS Rules
Medicare Advantage rate cuts are coming next year, but prior-auth provisions slated for 2026 could tide palmier payer partnerships.
Payer
Humana Expands Prior Auth. Partnership With Cohere Health
The platform is giving physicians faith in quick prior authorization turnaround.
Payer
Infographic: Nine States Cover Wegovy Through Medicaid
Some states are hesitant to cover the popular drugs.
Revenue Cycle
Private Payers Retain Profits by Denying, Delaying Claims: What Rev Cycle Leaders Can Do About It
While health systems are doing their best to maintain financial stability, payers are doing their best to protect their profitability.
Payer
Feds Pressuring Payers to Increase Assistance Efforts After Change Attack
U.S. officials are putting the pressure on payers to take more targeted action.
Technology
Timeline of the Change Healthcare Attack
The Change Healthcare ransomware attack has affected health systems nation-wide for almost a month now.
Payer
The Change Healthcare Attack: What Payers Need To Know
The attack is rippling through the healthcare industry and affecting everyone, including payers.
Payer
Gold Carding and Payers: What To Know
Gold Carding is expanding across the country with several states already implementing the legislature in some way.
Payer
States target health insurers’ ‘prior authorization’ red tape
A spokesperson for Cigna says the insurer uses prior authorizations for popular drugs such as Mounjaro to help ensure that...
Payer
States Target Health Insurers' 'Prior Authorization' Red Tape
Last year, lawmakers in 29 states and Washington, D.C., considered some 90 bills to limit prior authorization requirements.
Revenue Cycle
CMS Finalizes Prior Auth Rule With Added Payer Requirements
The requirements will make exchanging health data more efficient and reduce administrative burden.
Revenue Cycle
How We Got Here: CMS Prior Authorization Policy Review Rule
Prior authorization has been a consistent pain point for revenue cycle leaders, but hopefully not much longer.