UnitedHealthcare to cut prior authorization for 30% of services. Here’s what to know.

UnitedHealthcare recently announced a significant policy shift that will eliminate “prior authorization” requirements for 30% of medical services that previously required insurer approval. This change is aimed at reducing red tape and speeding up access to patient care, addressing the longstanding issue of prior authorizations in the health insurance industry.

Prior authorizations have been a point of contention for health care providers and patients alike, with critics pointing out the time-consuming nature of the process and its impact on patient care. The American Medical Association has found that physicians’ offices spend an average of 12 hours per week seeking insurer approval for medical treatments, taking away valuable time that could be spent providing medical care. Additionally, some patients have reported being denied treatment by their insurance companies due to prior authorization requirements.

UnitedHealthcare, the largest health insurer in the United States, stated that prior authorization is currently required for 2% of the medical services covered under its policies. The company reported that about 92% of these authorizations are approved within 24 hours. CEO Tim Noel emphasized the importance of prior authorization as a safeguard but also acknowledged the need to eliminate unnecessary barriers to care.

The company specified that the following procedures will no longer require prior authorization: select outpatient surgeries, some diagnostic tests such as echocardiograms, some outpatient therapies, and some chiropractic care. A full list of services that will no longer require prior authorization will be posted on UHCProvider.com before the changes take effect.

UnitedHealthcare plans to implement these changes by the end of 2026. This move aligns with a trend in the health insurance industry, as other insurers represented by the trade association Health Insurance Plans (AHIP) have also taken steps to streamline prior authorization processes. This includes major insurers like Blue Cross Blue Shield, Humana, Kaiser Permanente, and UnitedHealthcare.

In conclusion, UnitedHealthcare’s decision to eliminate prior authorization requirements for a significant portion of medical services reflects a broader industry shift towards reducing administrative burdens and improving access to care for patients. This change is expected to have a positive impact on both healthcare providers and patients, ensuring that necessary treatments are delivered in a timely manner.