Forbes contributors publish independent expert analyses and insights. Richard Menger is a neurosurgeon and a political scientist. You have worked for your company for 15 years. You suffer from chronic ...

The need to fix healthcare’s antiquated prior authorization (PA) process remains a hot-button issue in the industry, garnering policy attention and spurring the development of myriad technology ...

Please provide your email address to receive an email when new articles are posted on . Most medications in allergy and asthma care require prior authorization. Providers should screen for failed ...

Medicaid Managed Care Organizations (MCOs) denied one out of eight prior authorization requests in 2019, according to a new report from the Office of Inspector General (OIG). The OIG review included ...

There is a good reason for health insurers to occasionally require prior authorization for medical treatment. If a doctor ...

It's no secret that burnout is a struggle across the healthcare industry, and the complex, time-consuming prior authorization process is one contributor. In fact, the U.S. Surgeon General addressed ...

Prior authorizations (PAs) add value. However, with all of the negative talk in the healthcare industry about PAs, it’s worth remembering why health plans created the process in the first place. As ...

Payers must continue to assess their prior authorization practices to uphold the goals of clinical quality, safety, and utilization management. Like many others, I was drawn to be a doctor because I ...

This was a question that Chris Severn, CEO of Turquoise Health, a price transparency company, asked of Don Antonucci, CEO of Providence Health Plan at a fireside chat in Las Vegas. The chat was part ...

Prior authorization of drugs, diagnostic testing, or other medical services “is intended to ensure that health care services are medically necessary by requiring providers to obtain approval before a ...

When Paula Chestnut needed hip replacement surgery last year, a pre-operative X-ray found irregularities in her chest. As a smoker for 40 years, Chestnut was at high risk for lung cancer. A specialist ...

Use of prior authorization in the Medicare Advantage (MA) program continues to increase, according to a report from KFF. More than 46 million prior authorization requests were submitted to Medicare ...