On April 10, the Centers for Medicare & Medicaid Services (CMS) announced it is proposing changes to slash long waiting ...

Prior authorization forces doctors to spend 13 hours a week fighting insurers. New federal rules are changing that—here's what you need to know.

Issued Friday, the proposed rule also would require full disclosure of claims denials and appeals outcomes, according to a ...

Telligen Honored with the Richard L. Doyle Award for Innovative ‘Blue-Ribbon’ Prior Authorization Program ...

Drugs were left out of a 2024 rule streamlining prior authorizations, including by making decisions electronic and requiring ...

HHS is proposing to adopt certain HL7 FHIR standards and implement specifications for transactions related to prior ...

Delivered strong topline performance with first quarter revenue expected to be $14.7 million to $14.8 million, approximately 20% growth compared ...

For years, the only way to take a GLP-1 weight-loss drug was to inject it. That changed in late 2025, when the FDA cleared a ...

A 2024 CMS rule now requires payers, including Medicare Advantage plans, Medicaid, CHIP and ACA exchange carriers, to publicly report prior authorization metrics for the first time. The public ...

The feds have AI reviewing whether claims through traditional Medicare are 'medically necessary' — upending longstanding ...

Each prior auth transaction costs practices between $20 and $30 ...

Prior authorization, a process that requires physicians to obtain approval from health care insurers before certain treatments are covered, may keep patients from filling prescriptions for two ...