The process of prior authorization, which requires pre-approval from health insurers for certain medical treatments and medications, has been a source of frustration for many patients and healthcare providers. While it serves as a check on unnecessary spending, many physicians express concerns about delays in care that can lead to patients abandoning recommended treatments. A survey by the American Medical Association in 2025 indicated that 61 percent of doctors are worried that the use of artificial intelligence (AI) in this process may lead to increased denials of necessary treatments. Proponents of AI suggest that it could streamline the approval process for straightforward claims, potentially reducing delays, but there is significant resistance due to fears of wrongful denials.
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The Role of AI in Prior Authorization Processes
Prior authorization is a necessary process for obtaining approval from health insurers for medical treatments, but it can lead to delays that affect patient care. A 2025 survey indicated that many physicians are concerned that the introduction of AI in this process may worsen denial rates for necessary treatments, despite its potential to expedite approvals for clear cases.
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Will AI fix prior authorization—or make it worse?
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The Role of AI in Prior Authorization Processes