On my HMO plan, I was lead to believe they use Express Scripts. My Endocrinologist writes ... Going to notify Medicare next.

There is a tendency to overlook the multiple factors and stakeholders that contributed to the Rx opioid crisis. This includes ...

You may also need pre-approval, or prior authorization, for coverage of certain care. Prior authorization is a review of a requested health care service by your regional contractor to see if ...

And the majority of physicians said prior authorization processes and forms were difficult to understand, and 58% said they did not have enough staff to handle authorizations.

Opens in a new tab or window Medicare Advantage plans have increased their use of prior authorization and appear to be targeting certain types of care -- such as expensive post-acute hospital care ...

The policy, CMS-1717-FC from the federal government, requires that patients with Medicare receive prior authorization to undergo these surgical procedures at hospital outpatient surgery departments.

The three largest Medicare Advantage insurers have dramatically increased prior authorization requirements and denials for post-acute care, often using algorithms, to enhance profits, a new report ...

Opinions expressed by Forbes Contributors are their own. Bruce Japsen writes about healthcare business and policy. Physician complaints about prior authorization – the vehicle that requires them ...

The largest Medicare Advantage insurers have prioritized profits over patient care by increasing the use of prior authorization in recent years to frequently deny post-acute care services to older ...

Going to notify Medicare next. I'm forced to use Express Scripts, which has been a ... after getting the new prescription because of prior authorization issues. Dr sent the prescription in on ...

The policy, CMS-1717-FC from the federal government, requires that patients with Medicare receive prior authorization to undergo these surgical procedures at hospital outpatient surgery departments.