Manual prior authorization places significant financial and administrative burdens on providers and health plans. However, redesigning the workflow and leveraging automation to move the prior ...

CMS finalized a rule Jan. 17 aiming to streamline the prior authorization process and improve the electronic exchange of health information that it estimates will save $15 billion over 10 years. ACHP ...

More than half of providers and 43% of payers have yet to start work on the application programming interface requirements of the interoperability and prior authorization final rule, according to a ...

An online survey identified that documentation requirements and communication issues with health plans are associated with providers modifying clinical decisions to avoid medication prior ...

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.