BHM Healthcare Solutions

FEBRUARY 7, 2024

Prior Authorization is designed to prevent unnecessary expenses. In this blog post, we will delve into the nuances of prior authorization, exploring its effects on payers and unveiling best practices for a more sustainable and efficient healthcare system. The post Prior Authorization: How Does It Affect Payers?

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FierceHealthIT

APRIL 18, 2024

Medication management platform DrFirst this week closed its acquisition of Myndshft Technologies, an AI-enabled benefits and prior authorization verification platform. |

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BHM Healthcare Solutions

FEBRUARY 13, 2024

Dive into our latest insight detailing 10 crucial terms for prior authorization, essential for navigating healthcare effectively. The post 10 Essential Terms You Should Know About Prior Authorization appeared first on BHM Healthcare Solutions.

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FierceHealthIT

MAY 16, 2023

UnitedHealthcare defends controversial prior authorization policy for colonoscopies fdiamond Tue, 05/16/2023 - 16:43

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Redox

JANUARY 24, 2024

My debut focused on how the CMS proposed Interoperability and Prior Authorization rule would dramatically improve prior authorization processes with electronic processing via APIs. CMS just finalized the CMS Interoperability and Prior Authorization Final Rule CMS-0057-F , or what many have called the “Interop 3” rule.

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FierceHealthIT

JULY 20, 2023

The Office of Inspector General (OIG) is urging the feds and states to take on greater oversight of prior authorization denials in Medicaid managed care. | The Office of Inspector General is urging the feds and states to take on greater oversight of prior authorization denials in Medicaid managed care.

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FierceHealthIT

SEPTEMBER 14, 2023

Tens of thousands of Kaiser Permanente’s workers have voted to authorize a labor strike should no contract deal be in place by Sept. 30, unions announced Thursday. | The total could grow by nearly 20,000 more as other unions tally their votes. The large nonprofit would need to reach a contract deal by Sept. 30 to avoid the walk-off.

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Healthcare IT Today

FEBRUARY 16, 2024

The latest round of funding will fuel the company’s expansion to meet the increasing demand for Cohere’s intelligent prior authorization platform. million intelligent prior authorizations annually for more than 15 million health plan members and 420,000 healthcare providers nationally.

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FierceHealthIT

MARCH 29, 2023

UnitedHealthcare to begin reducing prior authorizations this summer pminemyer Wed, 03/29/2023 - 17:02

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Healthcare IT Today

MARCH 23, 2022

Prior Authorizations are the bane of doctors existence and they affect the patient as well. Recently, I was able to sit down with Joe Anstine, CEO, and co-founder of PriorAuthNow , a company that is working to ease the tensions and difficulties of prior authorizations, to dive into this topic. Many people may not know […].

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Healthcare IT Today

APRIL 12, 2022

One of the banes of healthcare is prior authorizations. While every doctor and medical staff I know hate prior authorizations, the payers have a good reason for them. Just mention of the phrase makes the hearts of doctors and their staff break. They want to make sure they’re paying for the proper care. It’s a […].

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FierceHealthIT

DECEMBER 13, 2023

At stake are access to the nation's most frequently used abortion drug and the regulatory authority of the FDA. Jackson ruling.

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FierceHealthIT

MAY 30, 2023

UnitedHealthcare, docs still at odds over prior authorization policy for colonoscopies fdiamond Tue, 05/30/2023 - 17:17

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BHM Healthcare Solutions

MAY 5, 2023

Prior authorization (PA) is a process that insurance companies use to determine whether they will cover the cost of a medical treatment or medication. However, the process of prior authorization can be time-consuming and complicated for healthcare providers, leading to delays in patient care. or Prior Authorization AI.

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BHM Healthcare Solutions

MAY 24, 2023

Medicare Advantage growth aggravates prior authorization burdens in the several ways. Most medical groups, providing care to patients with Medicare Advantage plans, must comply with more prior authorization requirements. Efforts to streamline and standardize the prior authorization process can help alleviate some of these burdens.

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Mobi Health News

JUNE 29, 2023

The hybrid platform offers Medicare Advantage recipients behavioral health services and will use the funds to grow its partnerships with insurance providers.

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Mental health Medicare 237

BHM Healthcare Solutions

FEBRUARY 16, 2023

Prior authorization (PA) is a utilization management process used by some health insurance companies for determining if the patient’s health policy covers a prescribed services, like procedures, tests, or medications, before services are rendered. Calls are recorded and transcribed, focusing doctors on patient care.

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Health Policy 52

FierceHealthIT

APRIL 5, 2023

CMS finalizes changes to Medicare Advantage star ratings, prior authorization reforms rking Wed, 04/05/2023 - 16:14

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FierceHealthIT

JUNE 28, 2023

Author Health banked $115 million for its new platform offering care and treatment for Medicare Advantage members with serious mental illness and substance use disorders. Author Health banks $115 million for its new platform offering care and treatment for Medicare Advantage members with serious mental illness and substance use disorders.

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FierceHealthIT

JANUARY 18, 2023

Black patients get better care when nurse practitioners have full practice authority: study. Wed, 01/18/2023 - 15:46.

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FierceHealthIT

SEPTEMBER 8, 2023

Prior authorization will become less of a hassle for physicians in Blue Cross Blue Shield of Michigan’s network, BCBSM officials hope, as they roll out an effort to relax about 20% of prior authori | Blue Cross Blue Shield of Michigan unveiled an effort to relax about 20% of prior authorization requirements by utilizing technology and “gold carding” (..)

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FierceHealthIT

JULY 28, 2023

Lobbying groups representing different camps of the healthcare industry have come together to urge the Centers for Medicare & Medicaid Service (CMS) to reconsider “conflicting regulatory propos | The American Hospital Association, American Medical Association and Blue Cross Blue Shield Association penned a joint letter highlighting "conflicting" (..)

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FierceHealthIT

FEBRUARY 8, 2023

Meta-analysis authors want to see more evidence fdiamond Wed, 02/08/2023 - 15:47 Do masks really protect against COVID-19?

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FierceHealthIT

MARCH 14, 2023

Surveyed physicians say prior authorization harms patient outcomes, burns healthcare resources dmuoio Tue, 03/14/2023 - 11:55

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Electronic Health Reporter

JUNE 26, 2019

health insurance companies have begun implementing prior authorization processes. However, shifting prior authorization […]. The article Better Prior Authorization Outcomes Through “Augmented Intelligence” appeared first on electronichealthreporter.com. Recently, major U.S.

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FierceHealthIT

DECEMBER 6, 2022

CMS proposes certain payers implement electronic prior authorization systems by 2026. Tue, 12/06/2022 - 17:04.

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FierceHealthIT

JANUARY 17, 2023

Providers press CMS to finalize prior authorization reforms to alleviate major administrative burdens. Tue, 01/17/2023 - 17:00.

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FierceHealthIT

DECEMBER 14, 2022

CMS proposes new Medicare Advantage and Part D reforms on prior authorization, marketing. Wed, 12/14/2022 - 17:09.

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FierceHealthIT

NOVEMBER 30, 2022

Mental health providers decry 'mind-numbing' prior authorization burdens as Senate debates reforms. Wed, 11/30/2022 - 13:13.

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Mental health 113

FierceHealthIT

SEPTEMBER 20, 2021

Kaiser Permanente union authorize strike vote amid stalled contract negotiations. Mon, 09/20/2021 - 15:16.

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FierceHealthIT

MARCH 15, 2023

ONC, CMS officials plot next reforms to entice adoption of electronic prior authorization rking Wed, 03/15/2023 - 13:08

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FierceHealthIT

MARCH 9, 2023

Prior authorization reform vital to combat nationwide clinician burnout crisis, US surgeon general says dmuoio Thu, 03/09/2023 - 15:03

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FierceHealthIT

FEBRUARY 13, 2023

Providers want more from CMS on prior authorization reform after proposed changes rking Mon, 02/13/2023 - 17:36

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FierceHealthIT

MAY 8, 2023

HHS' proposed HTI-1 rule draws criticism for what's excluded—electronic prior authorization aburky Mon, 05/08/2023 - 16:18

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Electronic Health Reporter

APRIL 2, 2019

Prior authorizations are hurting practices, the American Medical Association contends. According to the organization, prior authorization requirements have increased in the past five years, and 85 percent of physicians say the practice interferes with continuity of care. Illegal copying is prohibited. By Scott E.

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Mobi Health News

APRIL 21, 2020

Using a designated kit ordered by a doctor, patients will be able to self-swab and mail their samples to LabCorp testing facilities. The self-collection kits will be available in "most states" in the coming weeks.

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Electronic Health Reporter

JULY 27, 2020

Time may heal most wounds, but it has done little to lessen the sting of prior authorization. The article A Pain Point for Every Healthcare Stakeholder: Easing the Sting of Prior Authorization appeared first on electronichealthreporter.com. By Jeffrey Sullivan, chief technology officer of the cloud fax division, J2 Global, Inc.

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