UnitedHealthcare cuts prior authorization requirements by 30%

UnitedHealthcare volition destruct anterior authorization requirements for 30% of healthcare services that presently necessitate insurer approval, the institution said, with the changes acceptable to instrumentality effect by the extremity of 2026.

Among the services affected are echocardiograms and different diagnostic tests, prime outpatient surgeries, chiropractic care, and outpatient therapy, the institution said. A afloat database volition beryllium published connected UHCProvider.com earlier the changes instrumentality effect.

Pre-authorization presently touches astir 2% of UnitedHealthcare's full claims — a tiny stock that inactive amounts to millions of reviews annually. The insurer says it grants support connected astir 92% of those requests, with a emblematic turnaround of nether 24 hours.

UnitedHealthcare CEO Tim Noel said the announcement reflects however exertion backed by artificial quality tin alteration healthcare's fiscal system. The displacement allows the institution to emblem outlier providers done information investigation and code concerns with them one-on-one, alternatively than applying broad pre-approval requirements crossed full process categories, helium told The Wall Street Journal. "My anticipation is that patients and providers acquisition thing a batch different, a batch little abrasive," Noel said. He added that AI is not utilized to marque decisions to contradict care.

Submission requirements for anterior authorizations are besides being unified crossed UnitedHealthcare's concern segments — spanning Medicare, Medicaid, and employer-sponsored plans — the institution said. More than 70% of its anterior authorizations volition beryllium portion of a caller standardized submission process by year-end, UnitedHealthcare said.

The insurer has taken respective related steps successful caller months. On April 20, UnitedHealthcare said it would exempt galore agrarian attraction providers from anterior authorization requirements and accelerate payments to prime agrarian hospitals, with the programme expanding to astir 1,500 agrarian hospitals by autumn 2026. Earlier, the institution expanded a "gold card" programme that allows doc groups who travel evidence-based attraction guidelines to bypass immoderate authorization requirements.

UnitedHealthcare is not unsocial successful scaling backmost pre-approval requirements — Aetna, a portion of CVS Health, and Cigna Group person pursued comparable reductions, according to The Wall Street Journal. Across the industry, commercialized groups estimation that pre-authorizations person fallen by 11% since a coordinated betterment propulsion began successful 2025, though supplier organizations representing hospitals and physicians study that the applicable effect connected their administrative load has been modest, The Journal said.

UnitedHealthcare is simply a portion of UnitedHealth Group, which reported first-quarter 2026 results that bushed Wall Street expectations and raised its full-year nett forecast. The institution has besides undertaken a third-party reappraisal of its halfway concern practices, publishing an archetypal acceptable of reports successful December, and pledged to destruct and rebate immoderate profits from its idiosyncratic ACA offerings successful 2026.