This guide breaks down what separates enterprise-grade HME/DME billing platforms from glorified spreadsheets, which features actually move the needle on reimbursement rates, and how to evaluate ...

Prior authorization forces doctors to spend 13 hours a week fighting insurers. New federal rules are changing that. Here's ...

Athenahealth and CoverMyMeds joined forces to streamline how patients receive prescriptions that require prior authorization from payers. Athenahealth integrated CoverMyMed’s electronic prior ...

With CMS expanding its infrastructure for pre-payment review in traditional Medicare, here are five things practice leaders ...

RadNet is a national radiology provider with 344 imaging centers employing 8,000 people and 500 radiologists. It has regional networks in New Jersey, New York, Delaware, Maryland, California and ...

The relationship between payers and providers has been historically contentious, with prior authorization being one of the biggest pain points. The process remains a heavily manual and costly burden ...

SAN DIEGO--(BUSINESS WIRE)--XIFIN today announced prior authorization and appeals enhancements to its revenue cycle management platform XIFIN RPM, and a strategic partnership with Infinx to reduce the ...

Prior authorization software company Cohere Health closed a $50 million Series B extension. Investment firm Deerfield Management led the round with support for venture capital firms Define Ventures, ...

Prior authorization requirements cost the U.S. healthcare system an estimated $35 billion each year, and their overuse has triggered a backlash, stirring some policymakers into action. Whether these ...

For decades, Americans have endured a healthcare system where access to care is delayed not by clinical need, but by administrative demands with little benefit. Prior authorization, the process ...

New England Baptist Hospital has been grappling with a serious problem facing healthcare today — insurers demanding prior authorizations for services ordered by physicians. Meeting payers' ...

Does Medicare require prior authorization? Medicare Advantage plans often require prior authorization. But these coverage reviews are rare for original Medicare. That distinction changes in 2026. Many ...