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Prior Authorization Topic Center

The Latest

Commentary
Enhancing Provider Experience Through Electronic Prior Authorization
08/13/2024
Each year the American Medical Association (AMA) surveys its membership to ascertain their feedback concerning prior authorizations (PAs) and the impact of this service on their practice. Reliably, AMA members say that PAs are disruptive to...
Each year the American Medical Association (AMA) surveys its membership to ascertain their feedback concerning prior authorizations (PAs) and the impact of this service on their practice. Reliably, AMA members say that PAs are disruptive to...
Each year the American Medical...
08/13/2024
First Report Managed Care
Commentary
Payer-Provider Synergy: Aligning at the Fulcrum Points
08/05/2024
Payer-provider collaboration represents a crucial opportunity to bridge the gap between those who provide care and those who finance it. In this commentary, experts delve into strategies to help foster a collaborative relationship between...
Payer-provider collaboration represents a crucial opportunity to bridge the gap between those who provide care and those who finance it. In this commentary, experts delve into strategies to help foster a collaborative relationship between...
Payer-provider collaboration...
08/05/2024
First Report Managed Care
News
Increased Scrutiny of Prior Authorization: Are Payers Fully to Blame, and Can AI Improve the Process?
04/05/2024
The increased scrutiny of prior authorization, highlighted by media reports and government actions, prompts debate over payer responsibility while exploring the potential for AI to enhance the process.
The increased scrutiny of prior authorization, highlighted by media reports and government actions, prompts debate over payer responsibility while exploring the potential for AI to enhance the process.
The increased scrutiny of prior...
04/05/2024
First Report Managed Care
Shannon Smith Headshot
Commentary
Adapting to Change: Navigating the New CMS Prior Authorization Guidelines in Health Care
04/02/2024

Shannon Smith, RN, BSN

Shannon Smith, RN, BSN
As the health care industry prepares for the Centers for Medicare & Medicaid Services (CMS) to implement new guidelines to streamline prior authorization procedures, significant operational changes are on the horizon for health care payers....
As the health care industry prepares for the Centers for Medicare & Medicaid Services (CMS) to implement new guidelines to streamline prior authorization procedures, significant operational changes are on the horizon for health care payers....
As the health care industry...
04/02/2024
First Report Managed Care
Dr Brian Covino
Interview
Green Lighting Solutions to Address Barriers in Health Care Prior Authorizations
03/05/2024

Featuring Brian Covino, MD, CMO, Cohere Health

Featuring Brian Covino, MD, CMO, Cohe...
There are several barriers to adopting electronic prior authorization in health care. With financial incentives and standardized processes, there is still room for improvement. An expert introduces the concept of green lighting, a data-driven...
There are several barriers to adopting electronic prior authorization in health care. With financial incentives and standardized processes, there is still room for improvement. An expert introduces the concept of green lighting, a data-driven...
There are several barriers to...
03/05/2024
First Report Managed Care

Newsfeed

Commentary
Enhancing Provider Experience Through Electronic Prior Authorization
08/13/2024
Each year the American Medical Association (AMA) surveys its membership to ascertain their feedback concerning prior authorizations (PAs) and the impact of this service on their practice. Reliably, AMA members say that PAs are disruptive to...
Each year the American Medical Association (AMA) surveys its membership to ascertain their feedback concerning prior authorizations (PAs) and the impact of this service on their practice. Reliably, AMA members say that PAs are disruptive to...
Each year the American Medical...
08/13/2024
First Report Managed Care
Commentary
Payer-Provider Synergy: Aligning at the Fulcrum Points
08/05/2024
Payer-provider collaboration represents a crucial opportunity to bridge the gap between those who provide care and those who finance it. In this commentary, experts delve into strategies to help foster a collaborative relationship between...
Payer-provider collaboration represents a crucial opportunity to bridge the gap between those who provide care and those who finance it. In this commentary, experts delve into strategies to help foster a collaborative relationship between...
Payer-provider collaboration...
08/05/2024
First Report Managed Care
News
Increased Scrutiny of Prior Authorization: Are Payers Fully to Blame, and Can AI Improve the Process?
04/05/2024
The increased scrutiny of prior authorization, highlighted by media reports and government actions, prompts debate over payer responsibility while exploring the potential for AI to enhance the process.
The increased scrutiny of prior authorization, highlighted by media reports and government actions, prompts debate over payer responsibility while exploring the potential for AI to enhance the process.
The increased scrutiny of prior...
04/05/2024
First Report Managed Care
Shannon Smith Headshot
Commentary
Adapting to Change: Navigating the New CMS Prior Authorization Guidelines in Health Care
04/02/2024

Shannon Smith, RN, BSN

Shannon Smith, RN, BSN
As the health care industry prepares for the Centers for Medicare & Medicaid Services (CMS) to implement new guidelines to streamline prior authorization procedures, significant operational changes are on the horizon for health care payers....
As the health care industry prepares for the Centers for Medicare & Medicaid Services (CMS) to implement new guidelines to streamline prior authorization procedures, significant operational changes are on the horizon for health care payers....
As the health care industry...
04/02/2024
First Report Managed Care
Dr Brian Covino
Interview
Green Lighting Solutions to Address Barriers in Health Care Prior Authorizations
03/05/2024

Featuring Brian Covino, MD, CMO, Cohere Health

Featuring Brian Covino, MD, CMO, Cohe...
There are several barriers to adopting electronic prior authorization in health care. With financial incentives and standardized processes, there is still room for improvement. An expert introduces the concept of green lighting, a data-driven...
There are several barriers to adopting electronic prior authorization in health care. With financial incentives and standardized processes, there is still room for improvement. An expert introduces the concept of green lighting, a data-driven...
There are several barriers to...
03/05/2024
First Report Managed Care
Videos
Bridging the Gaps in Prior Authorization: Challenges, Solutions, and Collaboration for Better Patient Care
11/13/2024
David Sand, MD, MBA, chief medical officer at ZeOmega, discusses the challenges of prior authorization, emphasizing the need for transparency, evidence-based standards, collaboration between payers and providers, and the potential for...
David Sand, MD, MBA, chief medical officer at ZeOmega, discusses the challenges of prior authorization, emphasizing the need for transparency, evidence-based standards, collaboration between payers and providers, and the potential for...
David Sand, MD, MBA, chief...
11/13/2024
First Report Managed Care
News
Using Deep Learning to Measure MS-Specific Brain Damage Beyond Aging
11/11/2024
A new study published in Neurology aimed to differentiate age-related brain changes from multiple sclerosis (MS)-specific neurodegeneration using MRI.
A new study published in Neurology aimed to differentiate age-related brain changes from multiple sclerosis (MS)-specific neurodegeneration using MRI.
A new study published in...
11/11/2024
First Report Managed Care
News
Adverse Event Data Suggest Selective β1-blockers Pose Asthma Risk
11/11/2024
The risks of asthma and asthma-like adverse events appear to be higher with selective β1-blockers than with nonselective blockers and α- and β-blockers.
The risks of asthma and asthma-like adverse events appear to be higher with selective β1-blockers than with nonselective blockers and α- and β-blockers.
The risks of asthma and...
11/11/2024
First Report Managed Care
News
RNAi Therapies Offer New Hope for Patients With Hereditary Transthyretin Amyloidosis
11/08/2024
RNA interference (RNAi)-based treatments for hereditary transthyretin amyloidosis (ATTR) have shown remarkable promise, offering new hope for patients with this rare but devastating genetic disorder.
RNA interference (RNAi)-based treatments for hereditary transthyretin amyloidosis (ATTR) have shown remarkable promise, offering new hope for patients with this rare but devastating genetic disorder.
RNA interference (RNAi)-based...
11/08/2024
First Report Managed Care
News
Revolutionary Single-Dose Gene Therapy Offers New Hope for Adults with Hemophilia B
11/08/2024
A groundbreaking gene therapy for hemophilia B has shown remarkable success in reducing bleeding episodes and improving the quality of life for adult patients, according to a recent international phase III clinical trial.
A groundbreaking gene therapy for hemophilia B has shown remarkable success in reducing bleeding episodes and improving the quality of life for adult patients, according to a recent international phase III clinical trial.
A groundbreaking gene therapy...
11/08/2024
First Report Managed Care
Jason Oswald Headshot
Commentary
The Impact of AI on Health Carrier Underwriting: Insights From Industry Experts
11/08/2024
"As AI continues to evolve, its integration into group health underwriting offers carriers new opportunities to enhance decision-making, streamline operations, and improve overall plan performance," said Jason Oswald, Director of Solution...
"As AI continues to evolve, its integration into group health underwriting offers carriers new opportunities to enhance decision-making, streamline operations, and improve overall plan performance," said Jason Oswald, Director of Solution...
"As AI continues to evolve, its...
11/08/2024
First Report Managed Care
News
Real-World Evidence Supports Efficacy and Safety of Selexipag in Patients With Pulmonary Arterial Hypertension
11/07/2024
Real-world data shows selexipag effectively improves functional class and risk category outcomes in patients with pulmonary arterial hypertension, regardless of maintenance dose.
Real-world data shows selexipag effectively improves functional class and risk category outcomes in patients with pulmonary arterial hypertension, regardless of maintenance dose.
Real-world data shows selexipag...
11/07/2024
First Report Managed Care
News
Clinical Predictors of One-Year Seizure Freedom After SLAH
11/06/2024
A study published in Annals of Clinical and Translational Neurology aimed to predict 1-year seizure freedom for patients undergoing stereotactic laser amygdalohippocampotomy (SLAH) for mesial temporal lobe epilepsy (MTLE) using a set of...
A study published in Annals of Clinical and Translational Neurology aimed to predict 1-year seizure freedom for patients undergoing stereotactic laser amygdalohippocampotomy (SLAH) for mesial temporal lobe epilepsy (MTLE) using a set of...
A study published in Annals of...
11/06/2024
First Report Managed Care
News
Efficacy and Outcomes of Neoadjuvant Immunotherapy in Lung Cancer
11/05/2024
A meta-analysis of 43 studies suggests that neoadjuvant chemoimmunotherapy may benefit patients with resectable NSCLC and low tumor PD-L1 levels for event-free survival, showing superior outcomes compared to neoadjuvant chemotherapy.
A meta-analysis of 43 studies suggests that neoadjuvant chemoimmunotherapy may benefit patients with resectable NSCLC and low tumor PD-L1 levels for event-free survival, showing superior outcomes compared to neoadjuvant chemotherapy.
A meta-analysis of 43 studies...
11/05/2024
First Report Managed Care
News
FDA Grants Accelerated Approval for Asciminib as First-Line Treatment in Ph+CML-CP
11/01/2024
Novartis received accelerated approval by the US Food and Drug Administration (FDA) for asciminib, a medication for adult patients with newly diagnosed Philadelphia chromosome-positive chronic myeloid leukemia in chronic phase (Ph+CML-CP).
Novartis received accelerated approval by the US Food and Drug Administration (FDA) for asciminib, a medication for adult patients with newly diagnosed Philadelphia chromosome-positive chronic myeloid leukemia in chronic phase (Ph+CML-CP).
Novartis received accelerated...
11/01/2024
First Report Managed Care

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