The idea behind it seems reasonable: Insurers want to ensure treatments are medically necessary before they pay for them. But ...

Doing your research is a good consumer practice for most purchases, but it’s especially important when choosing health insurance. If you buy a lemon of a car or a faulty TV, there are consumer ...

Strengthen your financial backup. Even with Medicare coverage, unexpected out-of-pocket expenses can pop up. Earn as much as ...

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.

If you’ve ever been a patient waiting—days, sometimes more than a week—for treatment approval, or a clinician stuck chasing it, you know what prior authorization feels like. Patients sit in limbo, ...

Trina Paul is a Breaking News and Personal Finance Writer at Investopedia, covering topics like retirement, consumer debt, and retail investing. She focuses on making complex financial topics ...

One increasingly subtle but important theme in US healthcare is the shift to care allocated by payers rather than providers. Historically, decisions on what care to provide patients were made by ...

For 2023, just under 400,000 prior authorization reviews for traditional Medicare beneficiaries were submitted to CMS. If you are considering signing up for an MA plan during Medicare Advantage open ...

As the year comes to a close, the Trump administration seems to be going in two different directions when it comes to the use ...

Democrats are raising concerns about a new CMS pilot program testing prior authorization requirements, which make patients get their health plan’s approval before receiving certain services, in ...

Traditional Medicare plan holders have typically not had to wait for prior authorization before receiving medical treatment. Until now. The Centers for Medicare & Medicaid Services (CMS) recently ...