Signalage UnitedHealthcare is shown in an office building in Phoenix, Arizona, on July 19, 2023.
Patrick T. Fallon | AFP | Getty images
Health plans among large American insurers said on Monday that they voluntarily agreed to accelerate and reduce earlier authorizations – a process that is often a big pain for patients and providers in getting and managing care.
Previous authorization ensures that providers receive approval from a patient's insurance company before they perform specific services or treatments. Insurers say that the process ensures that patients receive medically necessary care and enable them to control the costs. But patients and providers have beaten earlier authorizations in some cases, which leads to care delays or refigers and physician Burnout.
Dozens of plans among large insurers such as CVS Health” UnitedHealthcare” Cigna” Humana” Health Health And Blue Cross Blue Shield who is committed to a series of actions aimed at connecting patients to ensure faster and to reduce the administrative burden for providers, according to a release of AHIP, a trade group that represents health plans.
Insurers will implement the changes in different markets, including commercial coverage and certain medicine and medicaid plans. The group said that the Tweaks will benefit 257 million Americans.
The move comes months after the American health insurance industry was confronted with a flood of public recoil after the murder of the best executive of UnitedHealthcare, Brian Thompson. It builds on the work that different companies have already done to simplify their prior authorization processes.
One of the efforts is to determine a common standard for submitting electronic preceding authorization requests by the beginning of 2027. By that time, at least 80% of the approvals of electronic pre -authorization with all the necessary clinical documents will be answered in real time, according to the release.
This is intended to streamline the process and to alleviate the workload of doctors and hospitals, many of whom still request requests instead of electronically manually on paper.
Individual plans will reduce the types of claims that were subject to prior authorization requests in 2026.
“We look forward to working with payers to ensure that these efforts lead to meaningful and lasting improvements in patient care,” said Shawn Martin, CEO of the American Academy of Family Physicians, in the release.