Powered by Phare Access – the smart patient access hub of R1’s Phare Operating System – R1 Prior Authorization manages the ...
State insurance regulators unveiled sweeping prior authorization reforms that would scrap pre-approval requirements for "many ...
Abridge is partnering with real-time health information network Availity to fire up AI-powered prior authorization, expanding ...
The Centers for Medicare and Medicaid Services (CMS) is poised to launch a bold, new initiative to reduce waste, fraud and abuse. Starting January 1, 2026, the Wasteful and Inappropriate Service ...
Earlier this year, the Centers for Medicare & Medicaid Services (CMS) announced an agreement with Medicare Advantage plans to lessen the use of prior authorization, but the agency also said it would ...
The idea behind it seems reasonable: Insurers want to ensure treatments are medically necessary before they pay for them. But ...
Medicare is launching a new pilot program that will require prior approval for 17 health services using artificial intelligence tools. The Wasteful and Inappropriate Service Reduction (WISeR) model is ...
In October, CMS announced the launch of a new prior authorization demonstration that would introduce new requirements for select services. This comes just four months after news of an agreement ...
Sairohith Thummarakoti, industry advisory board member at Texas A&M University–Kingsville, tells MobiHealthNews about his upcoming session at the 2026 HIMSS Global Health Conference & Exposition in ...
Effective Jan. 1, the Trump administration will, for the first time in the 60-year history of Medicare, implement a pilot project in six states (with Ohio being one of them) that will use private, for ...
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