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 ...

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 ...

Of all the things that irritate physicians about health insurance, prior authorization might be at the top of the list. That didn’t stop the U.S. Centers for Medicare & Medicaid Service (CMS) from ...

Humana has announced several steps it will take to ease prior authorization requirements. The insurer said Tuesday that by the start of next year, it will have fully eliminated about a third of prior ...

OVERLAND PARK, Kan., July 09, 2020 (GLOBE NEWSWIRE) -- Beginning July 1, 2020, Medicare began requiring prior authorization for five types of surgery – blepharoplasty, botulinum toxin injections, ...

Beginning July 1, 2021, CMS will require prior authorization for cervical fusion with disc removal as well as implanted spinal neurostimulators. The strategy aims to ensure Medicare patients receive ...

Major health insurance providers have agreed to reduce the need for prior authorization — the requirement that patients must get approval from insurers before receiving certain treatments or risk ...