FierceHealthIT

NOVEMBER 13, 2023

Nine in 10 polled medical practices say their regulatory burden has increased over the past year with prior authorization, audits and appeals, the Medicare Quality Payment Program (QPP) and require | The latest annual poll of practices' regulatory burden outlined prior authorization, audits and appeals, Medicare QPP and other leading pain points (..)

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Medicare 142

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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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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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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Interoperability Leadership Medicare Digital Health 93

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 […].

Healthcare IT 91

Healthcare IT Health IT 91

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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FHIR Interoperability HIPAA 59

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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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 […].

Healthcare IT 101

Healthcare IT Health IT 101

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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FierceHealthIT

MARCH 29, 2023

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

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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 254

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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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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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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Healthcare IT 52

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.

Medicare 52

Medicare 52

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

Medicare 120

Medicare 120

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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Primary Care Medicare 106

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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Nursing 135

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

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

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" (..)

Medicare 98

Medicare 98

FierceHealthIT

MAY 7, 2024

Clover Health is raising its full-year adjusted EBITDA guidance and announced a share repurchase program of up to $20 million over the next two years, the insurtech said ahead of its first quarter | Clover Health announced an improved year-over-year adjusted EBITDA, insurance revenue and MCR during its first quarter earnings call.

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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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Medicare 117

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

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

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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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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