Anthem denies payment for emergency surgery
in this case Hien Shields underwent emergency spinal surgery after an accident to prevent permanent neurological damage. Anthem…
‘Is your plan for me to die?’: Cancer patients fighting for their lives — against health insurance red tape
Working for one of the largest health insurers in the country, Rachael Proffitt understands more than most Americans…
Does Medicare require prior authorization?
Does Medicare require prior authorization? Medicare Advantage plans often require prior authorization. But these coverage reviews are rare…
Medicare Tests Algorithms to Streamline Prior Authorization
Medicare is set to bring artificial intelligence (AI) into the core of its decision-making, testing whether algorithms can…
CMS trials prior authorization for select Medicare services
The Hubert H. Humphrey building in Washington, D.C., headquarters for the U.S. Department of Health and Human Services.…
Most Consumers Find Prior Authorization Is a Major Problem
About three-quarters of American consumers feel insurer prior authorization (PA) requirements are a problem, according to a survey…