UnitedHealthcare looks to reduce prior authorizations by 30% before end of 2026

The insurance division of UnitedHealth Group announced on Tuesday that it will be further easing prior authorization requirements it places on providers by roughly 30%. Previously, these selected services would have required approval before patient care could be delivered.

In an announcement, UnitedHealthcare said the change was made in an effort to make patient care “simpler and more affordable, while raising the bar for transparency and accountability across the marketplace.”

The insurer clarified that the change would be gradual and roll out through the year, with select outpatient surgeries, diagnostic tests, therapies and chiropractic care added to the list of prior authorization exemptions.

This includes common echocardiograms, UnitedHealthcare specified.

A full list of patient care procedures that will soon be automatically covered without need for additional approval from the company can be found by clicking here.

The company said the shift is part of its ongoing commitment to eliminate barriers to patient care approval, which typically plague Medicare Advantage plans but have also been known to delay care delivered to those within commercial insurance.

“Prior authorization is an essential safeguard but should only be used when it truly protects patients and improves care,” Tim Noel, CEO of UnitedHealthcare, said in a statement. “Eliminating these requirements is one more way we are working to make it easier for patients to get the care they need when they need it and ensure doctors can spend more time with their patients.”

“We are committed to further improving and refining our processes to make reviews quicker, simpler and more efficient,” he added.

The company claimed that only 2% of all patient care it covers is currently subject to a prior authorization delay. It added that it approves 92% of requests, with responses typically coming within 24 hours.

All the same, provider groups complained about the barrier, known to delay patient care and leave them uncertain about reimbursement.

UnitedHealthcare seems to be acknowledging the problem, stating openly that it’s working to “reducing the number of services that require prior authorization.” It pointed to its Gold Card program, which pre-approves providers who “adhere to evidence-based care guidelines.”

In addition, the company points to its digital and AI tools that have sped up the processing of claims and potential denials for coverage.

The company noted that it has fewer prior authorization requirements than other payers, signaling its commitment to eliminating the hurdle.

In January, UnitedHealthcare announced that it would be returning profits it earns from plans sold through the Affordable Care Act marketplace to customers. The details of that plan are still being finalized.