The Office of Inspector General has released a report examining prior authorization patterns from seven managed care companies, and based on the findings is urging increased oversight of prior ...
For beneficiaries in six states, AI could decide on some Medicare claims for non-emergency health care services.
Fighting rare bile duct cancer, Keaton Herzer used social media to overturn repeated insurance denials for lifesaving treatment and a liver transplant.
New AI-powered capability helps providers verify documentation and authorization readiness upfront, preventing denials ...
In addition to concerns about AI, the survey revealed concerns about delays in care, health care costs, and physician burnout. Most physicians surveyed expressed concern that health insurance ...
"Medically necessary" is often a four-letter word for patients.
It took years, a chain of conflicting decisions, and a health insurer switch before she finally won approval. She started treatment in January and now channels time and energy into helping other ...
Does Medicare require prior authorization? Medicare Advantage plans often require prior authorization. But these coverage reviews are rare for original Medicare. That distinction changes in 2026. Many ...
Depending on your health insurance policy, you may have noticed that you need to get permission from your insurer before it will pay for a medication, treatment or procedure your doctor prescribes — ...
When Sally Nix found out that her health insurance company wouldn’t pay for an expensive, doctor-recommended treatment to ease her neurological pain, she prepared for battle. It took years, a chain of ...
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