UnitedHealth to Make It Easier for Patients to Get a Range of Procedures
Insurer will reduce required authorizations by 30%, easing access to some tests, surgeries and therapy
UnitedHealth UNH 0.53%increase; green up pointing triangle Group plans to stop requiring doctors to get approvals for an array of procedures, tests and services, cutting back on a process that has long been detested by physicians and patients.
UnitedHealth, parent of the biggest U.S. health insurer, said the changes will slash the number of reviews by nearly a third starting later this year. Doctors have long complained about the paperwork they must complete to get insurers’ permission for care, which can lead to delays and denials.
UnitedHealthcare will stop requiring signoffs for tests including echocardiograms, some chiropractic care and certain outpatient surgeries. Also on the list is some outpatient therapy.
The insurer said it is using technology backed by artificial intelligence to help reduce the need for pre-authorization reviews.
The rollback is part of an effort by health insurers to counter a backlash against pre-authorizations. Rivals like CVS Health’s Aetna and Cigna Group have also made moves to ease these types of reviews.
Surveys of doctors and patients have shown that the insurers’ validation process is a top gripe. Industry organizations say that insurers have eliminated 11% of pre-authorizations since the groups launched a reform effort in 2025. Groups representing hospitals and doctors have said they have seen limited impact so far.
Insurers have long argued that preapproval requirements are important to prevent costly and unnecessary procedures and ensure patients’ safety.
Tim Noel, UnitedHealthcare’s chief executive, said his company’s announcement is an early signal of how technology backed by AI can change healthcare’s complicated financial system. Instead of broadly requiring pre-authorization for certain procedures, the insurer can increasingly use data analysis to quickly detect if particular healthcare providers have spiking patterns of questionable use and raise the issue directly with them, he said.
“My hope is that patients and providers experience something a lot different, a lot less abrasive,” he said, with the goal that the pre-authorization process will ultimately be far faster and more automated. Noel said AI doesn’t make decisions to deny care. The company said it currently approves 92% of requests, and the reviews take less than 24 hours on average.
UnitedHealth said around 2% of its total claims are now subject to the prior approval process. That still equates to millions of reviews a year.
UnitedHealthcare is aiming to standardize pre-authorization requirements among its different lines of business, which include Medicare, Medicaid and employer plans. The insurer is also removing the step for certain services that are nearly always approved, and for some that other insurers didn’t require.
The company had earlier pledged to improve pre-authorization with changes such as a “gold card” program that would let some approved doctor groups avoid some authorization requirements.
Artificial intelligence is being widely deployed by both insurers and hospitals to manage healthcare billing. A survey released last year by the National Association of Insurance Commissioners found that 68% of the responding health insurers were using, planning to use or considering using AI to review pre-authorizations for approval, and 12% said the same thing about denials.