Administrative costs are estimated to make up between 20 and 34 percent of US health care expenditures, roughly 1–4 percent of GDP. Academic and policy discussions generally characterize these costs ...

Centers for Medicare and Medicaid Services put forth a new set of rules to curb private insurance's use of prior authorization. These new rules will go into effect in 2026 and will impact care for the ...

WASHINGTON — Health and Human Services Secretary Robert F. Kennedy Jr. said Monday that the country’s largest health insurers have promised to take steps to streamline the often-criticized prior ...

If you’ve ever been a patient waiting—days, sometimes more than a week—for treatment approval, or a clinician stuck chasing it, you know what prior authorization feels like. Patients sit in limbo, ...

When your doctor decides you could benefit from a particular test or procedure, your insurance company might require documentation to prove it's necessary before agreeing to pay for anything.

Ahead of a final rule that would limit the amount of time insurers have to approve prior authorization requests and would require an electronic, FHIR API standard, UnitedHealth Group on Wednesday said ...