To control costs, nearly all health insurers use a system called prior authorization, which requires patients or their ...

An example of these comparisons was published last summer for non–small-cell lung cancer using a large payer prior authorization and claims database. 4 Although there was no significant difference in ...

Prior authorization is a commonly-cited pain point for physicians, leading to potentially lengthy delays in care as docs await insurers' OK to proceed with treatment.

Medicaid managed care organizations deny prior authorization requests at high rates, according to a recent report by the Office of Inspector General. Of the 115 MCOs the OIG analyzed, 12 had prior ...

For example, until a patient obtains prior authorization, she cannot start a particular treatment regimen—or in some cases obtain a necessary-but-expensive diagnostic test such as an MRI or CT scan.

Objective: To evaluate the effectiveness of an automated prior authorization (PA) system (SmartPA) in reducing use of and expenditures for cyclooxygenase-2 (COX-2) inhibitors.

The survey specifically asked doctors if the prior authorization process ever affected care delivery and led to a serious adverse event, such as a death, hospitalization, disability or permanent ...

Prior authorization is a sore subject for payers and providers. So what if it went away? In a recent fireside chat hosted by MedCity News, Don Antonucci, CEO of Providence Health Plan, shared his ...

State legislators working to speed up prior authorization process Doctors say that the process too often leads to delays in patient care and sometimes causes consumers to abandon treatment.