The platform addresses the health data challenge at its source by using its novel AI to clean, organize, and interpret ...

CMS has proposed extending its prior authorization interoperability framework to cover drugs for the first time, building on its 2024 rule that focused on medical items and services. The proposed rule ...

The Centers for Medicare & Medicaid Services April 10 released a proposed rule that would establish electronic standards for ...

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 ...

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

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, ...

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 ...

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' ...

Each prior auth transaction costs practices between $20 and $30 ...

But making sense of the numbers isn't easy, experts say ...

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 ...