The National Council of Insurance Legislators (NCOIL) has adopted the Prior Authorization Reform Model Act at its 2025 Annual ...

Arizonans enrolled in original Medicare will be test subjects for a controversial new program that makes use of AI to approve ...

Starting Jan. 1, traditional Medicare recipients in Washington state will face a new hurdle to get certain procedures covered — private AI companies that get paid based on how many claims they deny.

As health insurers increasingly rely on artificial intelligence to process claims, denials have been on the rise. In 2023, about 73 million Americans on Affordable Care Act plans had their claims for ...

HARRISBURG, Pa. — Pennsylvania health insurers denied about 3 million claims in 2024, and only a small share of consumers appealed those decisions, according to a new report released by the state. The ...

The average amounts of a hospital’s denied inpatient and outpatient claims have increased by 12% and 14%, respectively, with greater denial volumes also accompanying an uptick in payer’s audits, ...

Dealing with health insurance denials can be frustrating. There's no shortage of confusing terminology and processes that make it hard to resolve the issue. But before you try to contact your insurer ...

You might assume that your homeowner's insurance has you covered no matter what, but that's rarely true. Every year, thousands of homeowners are shocked when their claims are denied for reasons buried ...

AT FIVE. I WAS SHOCKED BECAUSE, I MEAN, AT THAT POINT, YOU KNOW, WHAT IS THE POINT OF HAVING INSURANCE IF SOMETHING WAS DENIED? REBECCA STRAUCH WAS TOLD THAT A PROCEDURE WAS MEDICALLY NECESSARY AND ...

In a typical U.S. hospital system, the revenue cycle is under constant pressure. A significant portion of this pressure comes from denied claims, which was estimated to be a $262 billion problem ...

Insurance companies deny one in five medical claims for patients in New York, forcing individuals into lengthy appeals processes to secure coverage and delaying care, a new report shows. Insurers ...