Health insurers move to streamline prior authorization process, promising quicker care

[BumRushDaShow]

Source: CBS News

Updated on: June 23, 2025 / 11:01 AM EDT


UnitedHealthcare, Kaiser Permanente and other major U.S. health insurers say they want to make it faster and easier for patients to obtain care. Health Insurance Plans (AHIP), a trade association that represents the health insurance industry, announced Monday that some of its biggest members are taking steps to streamline "prior authorization" — industry jargon for the process by which health care providers obtain approval from patients' insurance carriers to deliver care.

Prior authorization requests can be time-consuming for doctors, resulting in frustrating delays for patients in obtaining essential medical care. According to a survey from the American Medical Association, physicians' offices spend an average of 12 hours per week seeking approval for services from insurers, administrative hurdles that critics say take time away from providing care. As part of the new agreement, participating insurers have committed to a series of steps they say will speed up the sluggish process.

That includes creating a standardized system for submitting prior authorization online, reducing the amount of claims subject to prior authorization and ramping up real-time responses to requests. Such changes are scheduled to take effect in 2026 and 2027. "The health care system remains fragmented and burdened by outdated manual processes, resulting in frustration for patients and providers alike," AHIP CEO Mike Tuffin said in a statement. "Health plans are making voluntary commitments to deliver a more seamless patient experience and enable providers to focus on patient care, while also helping to modernize the system."

Shawn Martin, CEO of the American Academy of Family Physicians, said in a statement that the insurance industry initiative is a "step in the right direction," but that the real test will be the impact it has on the experiences of patients and physicians.

Read more: https://www.cbsnews.com/news/health-insurers-prior-authorization-blue-cross-cigna-united-healthcare/

[tonkatoy8888]

1. Alternate Headline

Insurers Agree to Tiny Reduction in Profits in Try to Save Own Necks From Angry Customers.

[not fooled]

2. Um, is this also a smokescreen for

"more AI"?

[50 Shades Of Blue]

3. My first thought!

[Brainfodder]

4. Heartless robot doctor visits incoming soon, and just as expensive of course?

Possible future:
Front desk people gone as a job?
Customer service is going to get even weirder?
Never a phone number, hey visit our website!?!
Talk to a human? Well for $120 up front, and $20 per minute....

[Irish_Dem]

5. They are promising to say no quicker.

And never pay providers.

[IbogaProject]

6. Window dressing

These aren't meaningful reforms, just window dressing by big insurance.

[bmichaelh]

7. Meaningless

What should happen; prior authorization should be determined by a group independent of insurance companies and the prior authorization would be portable regardless of insurance companies.

Or implement Medicare for All.

Here is my story on why this is meaningless.

I am a lymphoma survivor and in my third remission.
In 1990, I was diagnosed with lymphoma.
It returned in 2019; I tried 4 different treatments over 2 years; all failed.

in 2021, i tried a fifth treatment.
The fifth treatment provided me with remission.
Initially, my insurance company approved the treatment; then rescinded; was successfully appealed.

The reasoning for their rescinding was "eligible for stem cell transplant"

The actual reasoning was we want you to do this treatment because it will cost less in the long run than your current treatment.
But they did not say that.
Sometimes, insurers make decisions not based on medical efficacy but based on longtime cost.

If I had taken the stem cell transplant, I would probably lost my job.
Stem cell transplants can take up to 6 months.