The Centers for Medicare & Medicaid Services will require electronic prior authorization systems across Medicare Advantage, Medicaid, CHIP, and Marketplace plans starting Jan. 1, 2027. The move ...

With denial rates at 4 percent in 2025, the Dallas-based, tech-forward insurer is outperforming national averages.

Athenahealth and CoverMyMeds joined forces to streamline how patients receive prescriptions that require prior authorization from payers. Athenahealth integrated CoverMyMed’s electronic prior ...

The proposed rule aims to improve prior authorization for prescription drugs by establishing and requiring electronic prior ...

RadNet is a national radiology provider with 344 imaging centers employing 8,000 people and 500 radiologists. It has regional networks in New Jersey, New York, Delaware, Maryland, California and ...

Forbes contributors publish independent expert analyses and insights. Jesse Pines is an expert in healthcare innovation and wellness. This voice experience is generated by AI. Learn more. This voice ...

Zack Sigel is a writer and editor based in New York City. He has been managing editor at Policygenius and M1 Finance, where he led teams specialized in writing about business and finance, and he has ...

Forbes contributors publish independent expert analyses and insights. Jesse Pines is an expert in healthcare innovation and wellness. Health insurer prior authorization has increased considerably in ...

Prior authorization is the process by which your doctor must request approval from your Medicare plan before they can order a particular medication or medical service. Generally, Original Medicare ...

The first specialty medications added, Vivitrol and Epidiolex, are used to treat substance use disorder and epilepsy. “CVS Caremark and Surescripts share a commitment to transform the prior ...