These health care hurdles can stand in the way of getting treatment your doctor says you need. Here's what to know about how to deal with them.

"Medically necessary" is often a four-letter word for patients.

While there's a lot of buzz around prior authorization, it applies to fewer than 2% of claims. Prior authorization ensures care is both safe and aligned with the most up-to-date clinical guidelines.

Navigating the healthcare system can be a complex and frustrating experience for many patients. Among the many challenges, one of the most insidious barriers to timely care is prior authorization.

The new Medicare initiative would apply to claims for procedures such as steroid injections for pain management, electrical nerve stimulator implants, skin and tissue substitutes, devices for ...

To combat growing criticism of prior authorization delays by payers, Centers for Medicare & Medicaid Services finalized a rule Wednesday that requires health plans to send prior authorization ...

When the doctor says you need a prescription or treatment, sometimes you need approval from your health insurance first.

Nearly seven months after the fatal shooting of an insurance CEO in New York drew widespread attention to health insurers’ practice of denying or delaying doctor-ordered care, the largest U.S.

For beneficiaries in six states, AI could decide on some Medicare claims for non-emergency health care services.

New Brunswick, N.J.-based St. Peter’s Healthcare System CFO Garrick Stoldt said his health system is feeling ready for the new traditional Medicare prior authorization pilot that is set to begin Jan.

Remember that physician who wanted to develop a Current Procedural Terminology (CPT) code for prior authorizations? It hasn't happened yet, but he hasn't given up on it, either. In May, Alex ...