The administrative burden of utilization review processes like prior authorizations and concurrent review has long been a thorn in the side of healthcare providers. While prior authorizations have ...
Concurrent review is a utilization review process that occurs while a patient is actively receiving treatment, such as during a hospital stay. It evaluates the medical necessity and appropriateness of ...
Oncology utilization management often frustrates patients and payers, but collaboration and artificial intelligence can streamline processes and improve care quality, according to Vishnukamal Golla, ...
Health systems and health insurance plans spend enormous sums of money battling over how to be paid fairly — and these battles have only intensified with the growth of Medicare Advantage plans, which ...
I need to do a drug utilization evaluation (DUE) for a new product to be added to our formulary. What resources are available to develop a DUE? The formulary system encompasses facets of medication ...
JACKSONVILLE, Fla.--(BUSINESS WIRE)--Availity, the nation’s largest real-time health information network, celebrates the news that the country’s leading health insurers have pledged sweeping reforms ...
DELRAY BEACH, Fla., July 01, 2025 (GLOBE NEWSWIRE) -- Sunwave Health, a leading provider of healthcare software solutions, today announced the recent release of its MARA UR (Utilization Review), which ...
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