Insights

Mounting prior authorization denials worsen hospital-payer relations

Nov 21, 2022 11:31:34 AM / by Aspirion posted in Patient Experience, Denial Management, Outpatient Care, Inpatient Care, clinical denials

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Prior authorization requirements have been around for decades, and frustration from providers is nothing new. But a new report suggests that abuse of these policies is compounding hospitals’ already cratering finances and pushing relations with health insurers to the brink.

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Inpatient or Outpatient? How Humana’s Recent Statement Impacts Your Facility

Sep 9, 2020 8:30:00 AM / by Aspirion posted in Outpatient Care, CMS, Humana, Inpatient Care

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In a recently released Care Decision Insights, Humana announced that 145 formerly inpatient-only procedures are now approved at the outpatient level of care. According to Humana, the Centers for Medicare and Medicaid Services (CMS) says that its current inpatient-only list applies to traditional Medicare–but not ...

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