Streamlining the prior authorization process for a better health care experience

While prior authorizations are an important checkpoint to ensure a service or procedure is safe, medically appropriate and cost-effective, UnitedHealthcare understands that they can be a pain point for both members and care providers, especially if they cause unintended delays in care.

That’s why UnitedHealthcare continues to evaluate and take steps to speed up, reduce or even eliminate prior authorizations where appropriate. When our members seek care, over 98% of the time there is no prior authorization needed.¹

This is largely the result of a series of initiatives led by UnitedHealthcare to eliminate prior authorizations for common procedures, treatments and services. UnitedHealthcare plans to reduce prior authorization requirements by about 10% in 2025, after already reducing the total volume of prior authorizations by nearly 20% in 2023.

Another way UnitedHealthcare is streamlining prior authorizations is through its Gold Card Program, which recognizes and awards provider groups who consistently adhere to evidence-based care guidelines by reducing their total prior authorization request volume. Instead of submitting formal prior authorizations, these qualifying provider groups only need to follow a simple administrative notification process for most procedure codes. This helps to remove some of the administrative burden experienced by providers, allowing them to spend more time with their patients, which may lead them to deliver a higher quality of care and better health outcomes as a result.²

How this impacts employers: By streamlining the prior authorization process for members and providers, employers may not receive as many questions or complaints from their employees and overall employee satisfaction with their health plan may improve.