Derived from real-world prior authorization activity across tens of thousands of specialty practices who use SamaCare, the ...
With denial rates at 4 percent in 2025, the Dallas-based, tech-forward insurer is outperforming national averages.
Andrew Mellin, M.D., discusses Surescripts’ pilot program for prior authorization system, which pulls clinical data from EHRs ...
A Surescripts-led pilot has shown that medication prior authorization can be processed in as little as 18 seconds without AI, sharply reducing denials and appeals. The program’s expansion across 20 ...
PrescriberPoint, the AI-powered point-of-care platform, today announced its agentic AI prior authorization (PA) solution with the results of a clinical validation study. The healthcare provider ...
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Master the 2026 prior authorization shift
Major reforms to prior authorization are coming in 2026, with CMS, HHS, and industry leaders pledging to simplify and speed the process. New federal rules will mandate FHIR-based APIs, tighter ...
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. Jesse Pines is an expert in healthcare innovation and wellness. Health insurer prior authorization has increased considerably in ...
Forbes contributors publish independent expert analyses and insights. Jesse Pines is an expert in healthcare innovation and wellness. This voice experience is generated by AI. Learn more. This voice ...
Prior authorization has become one of the clearest points where administrative complexity directly affects patient care. For ...
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