Health insurers to speed up prior authorization process

NEW YORK (CBS, KYMA/KECY) - Changes designed to reduce red tape are in store for hundreds of millions of Americans who have private health insurance.

Insurers, including United Healthcare and Cigna, are among those who have agreed to speed up and reduce the process called "prior authorizations," which are approvals needed from the insurance company before health providers administer care.

"You know, you'll go to the doctor, right, a lot of times they'll tell you what the fix is, what the procedure is and then the doc goes, 'Wait! You should probably check with your insurance company because they might not actually cover it.' And so a lot of times what you need what is known as 'prior authorization,' [or] 'pre-approval,' and this has been a huge pain point for patients [and] providers. It takes a lot of time. It can be confusing."

Kelly O'Grady, correspondent, CBS News MoneyWatch

Beginning in January, participating insurers will reduce the scope of claims needing pre-approval. Patients can also expect more transparency on how those approval decisions are made.

By the start of 2027, health plans will aim to provide a standard process for submitting electronic pre-approval requests and answer 80% of those in real time.