Forbes contributors publish independent expert analyses and insights. Diane Omdahl is a Medicare expert who keeps her readers in the know. Over the last several years, prior authorization has become a ...

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

At least 18 states took action on health insurers’ use of prior authorization this year, a sign that lawmakers aren’t content to wait on federal regulators to step in on a key consumer and provider ...

Major health insurance providers have agreed to reduce the need for prior authorization — the requirement that patients must get approval from insurers before receiving certain treatments or risk ...

Highmark Health is partnering with Abridge in deploying ambient clinical documentation and real-time prior authorization across the integrated health system. Highmark Health, based in Pittsburgh, ...

Electronic health record providers are starting work that could transform how nursing homes grapple with prior authorization requests and length of stay determinations.

A breast cancer diagnosis should trigger immediate action. But for many patients, the journey to treatment begins with delays, often caused by outdated prior authorization (PA) processes. Designed to ...

Practicing physicians know all too well how prior authorization can disrupt the delivery of smooth, timely patient care. It’s a common cause of delays, administrative hurdles, and immense frustration ...

BRIDGEPORT, W.Va. — By the time Eric Tennant was diagnosed in 2023 with a rare cancer of the bile ducts, the disease had spread to his bones. He weighed 97 pounds and wasn’t expected to survive a year ...

For nearly three years, Eric Tennant endured chemotherapy infusions, rounds of radiation, biopsies, and hospitalizations that left him weak and depleted. Eric Tennant, of Bridgeport, West Virginia, ...