Researcher found 80% of claim denials were ultimately reversed, reinforcing long-standing concerns raised by AAOS and patient advocates ...

A new policy increased wait time for patients, but didn't speed up the move from hospital-based to outpatient-based operations. A new policy increased wait time for patients, but didn’t speed up the ...

Prior authorization — the process by which insurers review and approve or deny treatments prescribed by doctors — has become “the only piece of healthcare that every single stakeholder, including ...

CMS is launching a five-year Prior Authorization Demonstration for certain ambulatory surgical center (ASC) services beginning December 15, 2025, in 10 states, including Georgia, Florida, Tennessee, ...

Driving orthopedic outcomes sustainability through AI-enabled prior authorizations and physician-owned surgery centers improves care and financial control.

Payers must continue to assess their prior authorization practices to uphold the goals of clinical quality, safety, and utilization management. Like many others, I was drawn to be a doctor because I ...

In this week’s edition of InnovationRx, we look at efforts to improve prior authorization, commercializing Bell Labs’ IP portfolio, a new billionaire from Caris Life Sciences’ IPO, a big funding round ...

For the most part, Keyanna Jones and her husband thought they knew what to expect when their daughter Chloë had eye surgery last fall. Even Chloë, who was in kindergarten, had a good understanding of ...

Prior authorization delays and standardized codes that do not measure case variability are just two orthopedic policy disconnects surgeons say they face on a day-to-day basis. While insurance ...

SPRINGFIELD, Mo. (KY3) - Prior authorizations are standard this time of year as insurance changes. They’re essentially a request from your insurance asking for more information before agreeing to ...