"Medically necessary" is often a four-letter word for patients.

The Centers for Medicare & Medicaid Services Feb. 9 released its 2027 proposed standards for the health insurance marketplaces, including the issuers and brokers who assist marketplace enrollees.

Trump accounts now have another sign-up option following a Super Bowl ad that aired on Sunday. Here's what families need to ...

Optum has launched a pair of AI-driven prior authorization products, one designed to speed up submissions on the provider side and another to accelerate clinical reviews for payers. The ...

Nearly 53 million prior authorization requests were sent to insurers in 2024, compared with nearly 50 million in the prior ...

Blue Shield is designing a centralized, machine-readable policy repository to enhance policy digitization and automation, speeding up prior authorization decisions. The organization has partnered with ...