Kodiak Solutions said in a May 21 report that if payers used consistent criteria for making prior authorization/preficiation claim denials, the denial rates would be ...

Of the many tools that payers use to control costs, prior authorization ranks high on the list of what providers and patients find particularly vexing. However, Health Care Service Corporation hopes ...

Denials for outpatient care claims jumped 16% in the last three years, while inpatient care claims rose 26%, according to a May 21 report from Kodiak Solutions. Kodak, which monitors patient financial ...

CHICAGO, July 13, 2023 /PRNewswire/ -- Health Care Service Corporation (HCSC) is responsibly integrating both artificial and augmented intelligence to positively transform the prior authorization ...

The Centers for Medicare and Medicaid Services (CMS) has implemented prior authorization requirements for certain traditional ...

Health Care Service Corp., a health plan operator for 18 million members across Illinois, Montana, New Mexico, Oklahoma and Texas, is integrating artificial intelligence and augmented intelligence to ...

A group of chief medical officers of Illinois hospitals and advocates from the Illinois Health & Hospital Association are pushing state legislators to move a measure that targets prior authorization ...

Highmark was among more than 50 health insurers who pledged Monday to speed up and slim down prior authorization, the process through which patients and their doctors must seek insurance approval for ...

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.

Many states are enacting restrictions on insurers’ prior authorization policies, but these laws may increase costs and lead to other undesirable consequences. Many states have adopted or are ...

A Congressional advisory commission on Thursday declined to issue recommendations on improving Medicare Advantage prior authorizations, MA data transparency, or lowering payments to inpatient ...

Gift Article 10 Remaining As a subscriber, you have 10 articles to gift each month. Gifting allows recipients to access the article for free. Health Care Service Corp. is expanding a pilot integration ...