Prior authorization (PA) processes are a significant administrative burden for both plans and providers—even though approximately 85%+ of prior authorization requests are ultimately approved. As such, PA is an area commonly cited as ripe for automation, yet based on plan interviews, only 35%-40% of prior authorizations are currently automated.
How plans are (and aren’t) using AI to automate prior authorizations
Why trying to reduce administrative burden… takes a lot of administrative burden
August 11, 2022