"Medically necessary" is often a four-letter word for patients.

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 ...

There is a good reason for health insurers to occasionally require prior authorization for medical treatment. If a doctor ...

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 ...

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 ...

It's no secret that burnout is a struggle across the healthcare industry, and the complex, time-consuming prior authorization process is one contributor. In fact, the U.S. Surgeon General addressed ...

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 ...

This was a question that Chris Severn, CEO of Turquoise Health, a price transparency company, asked of Don Antonucci, CEO of Providence Health Plan at a fireside chat in Las Vegas. The chat was part ...

Prior authorization companies are moving into ambient listening, while ambient listening companies are expanding into prior authorization — a trend underscored by yet another partnership bridging the ...

Many private health insurers require medical providers to get approval before administering treatment, sometimes resulting in delayed or denied care for patients. Now, that tactic, known as prior ...

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 ...

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 ...