Prior Authorization Approval and Denial Rate Reporting Under New CMS Transparency Requirements
Insurers' denial rates vary wildly, and most denials get overturned on appeal.
Renata Osei-Bonsu
Senior Policy Correspondent
Renata Osei-Bonsu
Renata Osei-Bonsu spent a decade as a managed care analyst for a regional Blue Cross affiliate before transitioning to health policy journalism in 2011. She tracks federal and state payer regulations with a focus on how CMS rule-making lands on provider billing departments.
6 stories
CMS Interoperability and Prior Authorization Final Rule Implementation Timeline
Two compliance deadlines reshape how payers handle prior authorizations and deny claims.
Renata Osei-Bonsu
Medicare Advantage Plan Policy Divergence from Traditional Medicare
MA plans deny coverage far more often than Traditional Medicare does.
Renata Osei-Bonsu
Payer Bulletin Monitoring and the Lag Between Policy Change and Practice Awareness
Policy changes silently trigger claim denials weeks before practices notice the shift.
Renata Osei-Bonsu
Aetna Prior Authorization List Expansions by Specialty
Aetna's staggered PA updates across five systems create mid-cycle surprises for every specialty.
Renata Osei-Bonsu
UnitedHealthcare 2025 LCD Policy Shifts and Billing Impact
Five stacked billing rule changes will auto-deny claims across labs, imaging.
Renata Osei-Bonsu