These health care hurdles can stand in the way of getting treatment your doctor says you need. Here’s what to know about how ...
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 ...
Submit an appeal, even if you’re worried you’ll lose. Yaver said that, based on the research set to be published in her book, Coverage Denied: How Health Insurers Drive Inequality in the United States ...
Prior authorization has long been a sticking point between payers and providers, with payers arguing that it’s necessary to control costs and ensure that care is medically necessary and providers ...
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The 'prior auth' playbook for ulcerative colitis: cutting through the red tape
Don't let insurance delays stall your ulcerative colitis remission. Learn how to navigate prior authorization, step therapy, and specialty pharmacy hurdles.
Prior authorization is a common utilization-management tool among Medicare Advantage plans. However, service-, area-, and carrier-level patterns suggest variation in how plans use prior authorization.
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 ...
Payers have new deadlines to issue prior authorization decisions — 72 hours for urgent requests and seven days for non-urgent ones. Prior authorization is a process wherein a doctor must get approval ...
About 32% of Americans say prior authorization requirements are a major burden, more than billing confusion or finding appointments, according to the January 2026 survey.
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