Nashville, Tenn.-based HCA Healthcare has reported a modest reduction in prior authorization denials for accounts with two midnights or more, but still has "way too many denials," with large Medicare ...

Medicare Advantage’s prior authorization process has resulted in higher denial rates among three of the largest health ...

The Senate report extensively cites STAT’s investigation of the use of algorithms and artificial intelligence within Medicare ...

Community Health Systems Chief Financial Officer Kevin Hammons said payer denials have doubled from a year ago.

UnitedHealth, CVS and Humana used technology to increase MA prior authorization denials for post-acute services, boosting profits, according to a report from a Senate subcommittee.

As Medicare open enrollment begins on Oct. 15 (and continues through Dec. 7), millions of older Americans face the dilemma of ...

Medicare Advantage plan beneficiaries are essentially being penalized for using the health care that they pay for.

Humana faces significant challenges with rising denial rates and customer disenrollment, leading to a sharp decline in stock ...

On October 11, 2024, CMS issued a final rule establishing a new appeals process for Medicare beneficiaries who were initially admitted to a ...

Health systems are more likely to partner with Medicare Advantage plans when plans disclose reasonable claim denial processes ...

If we want to build on the promise of Medicare, then we are going to have to grapple directly with the power of corporate ...

Learn what to do when Medicare coverage for skilled nursing care ends, including what’s covered and options for what to do ...