Prior authorization requirements cost the U.S. healthcare system an estimated $35 billion each year, and their overuse has ...

New England Baptist Hospital has been grappling with a serious problem facing healthcare today — insurers demanding prior authorizations for services ordered by physicians. Meeting payers' ...

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

SAN DIEGO--(BUSINESS WIRE)--XIFIN today announced prior authorization and appeals enhancements to its revenue cycle management platform XIFIN RPM, and a strategic partnership with Infinx to reduce the ...

The relationship between payers and providers has been historically contentious, with prior authorization being one of the biggest pain points. The process remains a heavily manual and costly burden ...

Prior authorization software company Cohere Health closed a $50 million Series B extension. Investment firm Deerfield Management led the round with support for venture capital firms Define Ventures, ...

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. Health insurer prior authorization has increased considerably in ...

For decades, Americans have endured a healthcare system where access to care is delayed not by clinical need, but by administrative demands with little benefit. Prior authorization, the process ...

Have you ever walked into the pharmacy and been told that your prescription requires a prior authorization? But your healthcare professional prescribed something for you, and you brought in your ...

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 ...

Does Medicare require prior authorization? Medicare Advantage plans often require prior authorization. But these coverage reviews are rare for original Medicare. That distinction changes in 2026. Many ...