Prior Authorization

PCSK9 inhibitors are rejected by insurance providers at a higher rate compared with other guideline-indicated cardiometabolic drugs despite expanded labeling and reduced manufacturer cost, researchers reported.

The new CMS rule aiming to streamline prior authorization signals a major step forward for primary care, but the process could still use some improvement, according to experts.

More than one in five people with cancer did not receive clinician-recommended care due to prior authorization requirements, according to study results.

LAS VEGAS — Medication denials, forced medication switches and prior authorizations were among insurance-mandated barriers associated with negative clinical outcomes among patients with inflammatory bowel disease, according to data.

CMS has finalized a new final rule that aims to shorten prior authorization timelines and streamline processes to remove barriers to patient care, according to a press release.

Women in oncology continued to break barriers, unveil new research and accomplish goals in 2023.

GRAPEVINE, Texas — Prior authorization to approve elective total joint replacement may increase surgical wait times and lead to a high administrative burden, according to results presented here.

ORLANDO — Primary care physicians can use large language model artificial intelligence to substantially improve their practices, according to a presenter at OMED.

AUSTIN, Texas — Understanding the laws governing prior authorization is one way rheumatology professionals can ensure patients receive the drugs they need on time, a presenter said at the 2023 Rheumatology Nurses Society annual conference.

Medical coding historically has been a manual and disjointed process, with office managers, coding specialists or clinicians reviewing the data after patient visits and coding to the best of their abilities.