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 ...

Prior authorizations (PAs) add value. However, with all of the negative talk in the healthcare industry about PAs, it’s worth remembering why health plans created the process in the first place. As ...

The need to fix healthcare’s antiquated prior authorization (PA) process remains a hot-button issue in the industry, garnering policy attention and spurring the development of myriad technology ...

Forbes contributors publish independent expert analyses and insights. Richard Menger is a neurosurgeon and a political scientist. You have worked for your company for 15 years. You suffer from chronic ...

Natalie Tate, PharmD, is vice president of pharmacy at BlueCross BlueShield of Tennessee. Nationwide, prescription drugs are the costliest and commonly used heath plan benefit. Last year, BlueCross ...

Earlier this year, the Centers for Medicare & Medicaid Services (CMS) announced an agreement with Medicare Advantage plans to lessen the use of prior authorization, but the agency also said it would ...

When Sally Nix found out that her health insurance company wouldn’t pay for an expensive, doctor-recommended treatment to ease her neurological pain, she prepared for battle. It took years, a chain of ...

Prior authorizations have long been hated by many, but insurers call them an essential tool they use to control spending.

Please provide your email address to receive an email when new articles are posted on . Most medications in allergy and asthma care require prior authorization. Providers should screen for failed ...

Prior authorization of drugs, diagnostic testing, or other medical services “is intended to ensure that health care services are medically necessary by requiring providers to obtain approval before a ...

The prior authorization process continues to have a "devastating" effect on patient outcomes, physician burnout and employee productivity, according to a new physician survey from the American Medical ...

Editor’s note: David Charles is a practicing neurologist and chief medical officer at the Alliance for Patient Access. The first draft of this piece was written by Amanda Conschafter, communications ...