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Prior Authorization

All articles tagged with #prior authorization

UnitedHealthcare trims prior authorizations for most pediatric care
health1 day ago

UnitedHealthcare trims prior authorizations for most pediatric care

UnitedHealthcare will drop prior authorization for about two-thirds of pediatric services for members under 18, including many diagnostic tests, routine surgeries and subspecialty care, with authorization waivers for select procedures at leading pediatric hospitals. The move is meant to cut delays and paperwork; the insurer is conducting a data-driven review and aims to have over half of authorizations standardized by year’s end, with more than 70% incorporated into the new process, per CEO Tim Noel.

via KSL.com|
#health#healthcare-policy#insurance
Oz launches 29-member coalition to speed medical prior authorizations
healthcare-policy16 days ago

Oz launches 29-member coalition to speed medical prior authorizations

Dr. Oz unveiled a 29-member coalition of insurers, hospitals, and health-records companies to streamline prior authorization for medical procedures, aiming for faster, more transparent decisions by next January. The move expands a trend of insurer pledges to reduce administrative burden, with groups like AtlantiCare, Bon Secours Mercy Health, and Cleveland Clinic on board. Medicare’s AI-powered pre-treatment reviews have begun in some states, while critics warn about persistent paperwork and calls in Congress to curb prior authorizations for Medicare Advantage. The effort signals ongoing pressure to simplify and standardize the process across providers and payers.

via Axios|
#cms#dr-oz#electronic-prior-authorization
Insurer trims pre-approval hurdles for 30% of care
health24 days ago

Insurer trims pre-approval hurdles for 30% of care

UnitedHealthcare will drop prior authorization for about 30% of services by the end of 2026, including certain outpatient procedures, diagnostic tests (like echocardiograms), outpatient therapies, and chiropractic care, affecting about 257 million Americans. The company says reviews currently occur for roughly 2% of services and 92% are approved in under a day, aiming to speed care and reduce bureaucratic delays. This move follows a broader industry pledge to streamline prior authorizations, with doctors and patients having long complained about delays while insurers argue the reviews curb unnecessary care.

via USA Today|
#administrative-burden#health#health-insurance
UnitedHealth to Slash Pre-Authorization Hurdle with AI-Driven Approvals
business25 days ago

UnitedHealth to Slash Pre-Authorization Hurdle with AI-Driven Approvals

UnitedHealth said it will stop requiring approvals for a range of tests, surgeries and therapies, using AI to automate or eliminate prior authorizations for items like echocardiograms and certain outpatient services. The move aims to cut required authorizations by nearly a third this year and speed access to care, noting that prior authorizations currently apply to about 2% of services and most approvals occur within 24 hours. The policy shift signals how AI could reshape the financial side of healthcare across Medicare, Medicaid and employer plans.

via New York Post|
#ai-in-healthcare#business#health-insurance
UnitedHealthcare to drop prior authorization for 30% of services by 2026
healthcare25 days ago

UnitedHealthcare to drop prior authorization for 30% of services by 2026

UnitedHealthcare will eliminate prior authorization for about 30% of medical services that previously required insurer approval, including select outpatient surgeries, certain diagnostic tests (e.g., echocardiograms), some outpatient therapies, and some chiropractic care, with the change to take effect by the end of 2026. The company notes that prior authorization currently applies to about 2% of services and 92% are approved within 24 hours, while critics say the process creates administrative burdens and delays care; the move aligns with broader industry pressure to streamline authorization across insurers.

via CBS News|
#health-insurance#healthcare#healthcare-policy
Still Fighting for Coverage: The Unfinished Battle Over Medical Preauthorization
health-policy2 months ago

Still Fighting for Coverage: The Unfinished Battle Over Medical Preauthorization

Despite insurance pledges to simplify preauthorization, patients still face frequent denials and costly delays for necessary care. The piece follows Sheldon Ekirch and other patients who endured years of fights over IVIG and other treatments, including a successful reversal of a denial that required huge personal expenses, while COBRA transitions loom. Insurers tout changes like bundling and removing some approvals, but clinicians, patients, and experts question whether reforms will meaningfully improve access, a concern echoed by a 39% share of chronic-patient respondents in a KFF poll.

via CBS News|
#health-policy#health-policy-reform#insurance-denials
Major Insurers Pledge to Simplify Prior Authorization Process
health11 months ago

Major Insurers Pledge to Simplify Prior Authorization Process

RFK Jr and Dr Oz announced a voluntary agreement with insurance companies to reform prior authorization practices, aiming to reduce delays and denials of care, though past commitments have fallen short. The initiative seeks to standardize and speed up decisions, with industry and political support, amidst ongoing debates over healthcare access and insurance regulation.

via The Guardian|
#dr-oz#health#health-policy
Health Insurers and Officials Commit to Simplifying Prior Authorization Process
health11 months ago

Health Insurers and Officials Commit to Simplifying Prior Authorization Process

Health insurance plans in the U.S. have committed to simplifying and streamlining the prior authorization process to improve patient access, reduce administrative burdens, and enhance transparency, with specific actions including standardizing electronic submissions, reducing scope, ensuring continuity of care, and expanding real-time responses, aiming for significant improvements by 2026-2027.

via AHIP|
#health#health-insurance#healthcare-reform