Derived from real-world prior authorization activity across tens of thousands of specialty practices who use SamaCare, the ...

Andrew Mellin, M.D., discusses Surescripts’ pilot program for prior authorization system, which pulls clinical data from EHRs ...

The approach will be used for medical services that are commonly subject to prior authorization, such as orthopedic surgeries ...

Major reforms to prior authorization are coming in 2026, with CMS, HHS, and industry leaders pledging to simplify and speed the process. New federal rules will mandate FHIR-based APIs, tighter ...

PrescriberPoint, the AI-powered point-of-care platform, today announced its agentic AI prior authorization (PA) solution with the results of a clinical validation study. The healthcare provider ...

Prior authorization has become one of the clearest points where administrative complexity directly affects patient care. For ...

Bipartisan lawmakers have introduced the Medicare Advantage Improvement Act of 2026, aiming to curb prior authorization delays and align private plan rules with traditional Medicare. The move comes ...

Prior authorization is a common utilization-management tool among Medicare Advantage plans. However, service-, area-, and carrier-level patterns suggest variation in how plans use prior authorization.

Forbes contributors publish independent expert analyses and insights. Jesse Pines is an expert in healthcare innovation and wellness. Health insurer prior authorization has increased considerably in ...

Forbes contributors publish independent expert analyses and insights. Jesse Pines is an expert in healthcare innovation and wellness. This voice experience is generated by AI. Learn more. This voice ...

Prior authorization is the process by which your doctor must request approval from your Medicare plan before they can order a particular medication or medical service. Generally, Original Medicare ...