Major U.S. health insurers say they will streamline controversial process for approving care

Health plans nether large U.S. insurers said Monday they person voluntarily agreed to velocity up and trim anterior authorizations – a process that is often a large symptom constituent for patients and providers erstwhile getting and administering care.

Prior authorization makes providers get support from a patient's security institution earlier they transportation retired circumstantial services oregon treatments. Insurers accidental the process ensures patients person medically indispensable attraction and allows them to power costs. But patients and providers person slammed anterior authorizations for, successful immoderate cases, starring to attraction delays oregon denials and doc burnout.

Dozens of plans nether ample insurers specified arsenic CVS Health, UnitedHealthcare, Cigna, Humana, Elevance Health and Blue Cross Blue Shield committed to a bid of actions that purpose to link patients to attraction much rapidly and trim the administrative load connected providers, according to a merchandise from AHIP, a commercialized radical representing wellness plans. 

Insurers volition instrumentality the changes crossed markets, including commercialized sum and definite Medicare and Medicaid plans. The radical said the tweaks volition payment 257 cardinal Americans.

The determination comes months aft the U.S. wellness security manufacture faced a torrent of nationalist backlash pursuing the execution of UnitedHealthcare's apical executive, Brian Thompson. It builds connected the enactment respective companies person already done to simplify their anterior authorization processes. 

Among the efforts is establishing a communal modular for submitting physics anterior authorization requests by the commencement of 2027. By then, astatine slightest 80% of physics anterior authorization approvals with each indispensable objective documents volition beryllium answered successful existent time, the merchandise said. 

That aims to streamline the process and easiness the workload of doctors and hospitals, galore of whom inactive taxable requests manually connected insubstantial alternatively than electronically. 

Individual plans volition trim the types of claims taxable to anterior authorization requests by 2026. 

"We look guardant to collaborating with payers to guarantee these efforts pb to meaningful and lasting improvements successful diligent care," said Shawn Martin, CEO of the American Academy of Family Physicians, successful the release.