Blue Cross Blue Shield of Alabama says it's reforms will provide a simpler, more efficient system for patients and doctors.

What the Trump administration is calling a breakthrough in health insurance reform could streamline the process for patients ...

AI for prior authorization determinations in a recent survey. A Senate investigation shows they’re right to worry.

WASHINGTON - After meeting with the nation's top health officials, a consortium of health insurers has promised to take steps ...

"Prior authorization is often denied because a provider has not provided all of the necessary information," Moran told ...

Highmark is among the more than 50 health insurers who pledged Monday to speed up and slim down prior authorization, the ...

Major American insurers announced Monday that they have agreed to speed up and smooth out the processes involved with the ...

Several dozen insurers — including insurance giants UnitedHealthcare, Elevance, Aetna, Cigna and Kaiser Permanente — ...

The Centers for Medicare & Medicaid Services should create a centralized Medicare Advantage (MA) payment and claims portal as ...

Here’s what you need to know to appeal a health insurance denial, whether it involves a prior authorization request or a big bill following a procedure or treatment that you believe your ...

You also can take a look at a sample Wegovy appeal letter on the drug manufacturer website. You must submit your appeal within 6 months of receiving notice that your claim was denied.

The aim is not to eliminate prior authorization but to set up some guardrails so the system can’t be used to delay or deny clinically appropriate care. There’s plenty of AI-specific ...