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In the Calendar Year 2020 Outpatient Prospective Payment System/Ambulatory Surgical Center Final Rule (2020 OPPS Final Rule), the Centers for Medicare and Medicaid Services (CMS) established a prior ...

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 ...

Obtaining prior authorization for prescription medications is a time-consuming process for prescribers, patients and pharmacists that currently requires phone calls, faxes and hard-copy request forms.

The Biden administration released a proposal which, if finalized, would mandate Medicare Advantage (MA), Medicaid managed care, Affordable Care Act (ACA) plans and state Medicaid agencies implement ...

DrChrono, the developer of cloud-based electronic health record, practice management and medical billing tools, has announced an expanded partnership with CoverMyMeds, which makes software to help ...

The New Mexico Office of Superintendent of Insurance urges all health insurance consumers to actively monitor the status of any prior authorization requests submitted on their behalf. Prior ...

Forbes contributors publish independent expert analyses and insights. Diane Omdahl is a Medicare expert who keeps her readers in the know. My 90-year-old uncle, a retired county employee, has had a ...