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AI can improve the prior authorization process, but there needs to be more transparency, experts said during a recent panel held by KFF.

Nearly 1 in 5 consumers with health insurance say their insurer delayed or denied care in the past year due to its requirements for prior authorization, a process through which insurers can require patients to obtain approval in advance before they will agree to cover specific services. Insurers point to prior authorization as a tool<span class="readmore-ellipsis">…</span><a href="https://www.kff.org/other/event/feb-22-virtual-event-the-health-wonk-shop-prior-authorization-in-health-insurance-a-needed-tool-to-contain-costs-or-an-excessive-barrier-to-needed-...

More than a year after it was initially proposed, the Biden administration announced a final rule yesterday that will change how insurers in federal programs such as Medicare Advantage use prior authorization — a long-standing system that prevents many patients from accessing doctor-recommended care. “When a doctor says a patient needs a procedure, it is […]

Patients say the often time-consuming and frustrating rules or prior authorization create hurdles that delay or deny access to the treatments they need.

Prior authorization is a common cost-cutting tool used by health insurers that requires patients and doctors to secure approval before moving forward with many tests, procedures, and prescription medications.