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Prior Authorization Basic Listing

Feature Story
Prior Authorization in 2025: Key Trends Shaping the Future of Health Care
11/27/2024
Brian Covino, MD
In 2025, prior authorization undergoes a transformative evolution driven by regulatory changes, artificial intelligence enhancements, proactive utilization forecasting, and the integration of clinical nudges, all aimed at improving care...
In 2025, prior authorization undergoes a transformative evolution driven by regulatory changes, artificial intelligence enhancements, proactive utilization forecasting, and the integration of clinical nudges, all aimed at improving care...
In 2025, prior authorization...
11/27/2024
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
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
Dean Celia
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
Brian Covino, MD
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
Commentary
Unlocking Health Care Efficiency: CMS Overhauls Prior Authorization in Landmark Interoperability Rule—What Payers Need to Know Now
03/01/2024
Michael Gould
CMS has published the Interoperability and Prior Authorization final rule to drive transformative outcomes in the health care ecosystem, requiring payers and providers to adopt new standards and FHIR APIs to reduce inefficiencies and improve...
CMS has published the Interoperability and Prior Authorization final rule to drive transformative outcomes in the health care ecosystem, requiring payers and providers to adopt new standards and FHIR APIs to reduce inefficiencies and improve...
CMS has published the...
03/01/2024
First Report Managed Care
News
Impact of Patient Cost Sharing on Specialty Drug Utilization, Prior Authorization
05/26/2023
Julie Gould
“Higher levels of patient cost sharing reduce specialty drug use by increasing medication abandonment while generally decreasing initiation and persistence," researchers said.
“Higher levels of patient cost sharing reduce specialty drug use by increasing medication abandonment while generally decreasing initiation and persistence," researchers said.
“Higher levels of patient cost...
05/26/2023
First Report Managed Care
Conference Coverage
Adopting a Patient-Focused Approach to Prior Authorization Criteria
03/22/2023
Maria Asimopoulos
In a session at AMCP 2023, speakers shared the rationale driving current prior authorization practices, as well as how health plans might adopt a more patient-focused approach.
In a session at AMCP 2023, speakers shared the rationale driving current prior authorization practices, as well as how health plans might adopt a more patient-focused approach.
In a session at AMCP 2023,...
03/22/2023
First Report Managed Care
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