An insurance company often requires this type of preapproval for certain services, procedures, prescription medications, and medical supplies. Your healthcare team can often help you navigate this ...

One physician is making the case that prior authorization for procedures should be reported to insurance plans as a CPT code—though that proposal has been withdrawn for now. Alex Shteynshlyuger, M.D., ...

Prior authorization has long been a sticking point between payers and providers, with payers arguing that it’s necessary to control costs and ensure that care is medically necessary and providers ...

The Centers for Medicare & Medicaid Services (CMS) Interoperability and Prior Authorization Final Rule (CMS-0057-F) sets a new standard for how payers exchange data and respond to authorization ...

Providers are betting on artificial intelligence to ease the pain point of prior authorization, a new survey shows. Cohere Health, which provides clinical intelligence to insurers and risk-bearing ...

Three new studies highlighted the growing burden of prior authorization on both oncologists and patients. Findings from a survey of radiation oncologists, for instance, revealed that more than 80% ...

In 2025 alone, doctors and legislators across the country have already introduced more than 100 pieces of legislation meant to reform prior authorization. The cumbersome approval process is a leading ...