Cigna and UHC Move Towards Reducing Prior Authorization
In a significant development in the healthcare industry, both Cigna and United Healthcare (UHC) have recently taken steps to eliminate the prior authorization requirement for numerous procedure codes. United Healthcare plans will start eliminating the prior authorization requirement for many procedure codes that the insurer says account for nearly 20% of its overall prior authorization volume. Cigna, meanwhile, said it is removing nearly 25% of medical services from prior authorization requirements. This move is garnering cautious optimism from healthcare professionals and patients alike, as it aligns with key components of the consensus statement.
The consensus statement, which was agreed upon by several insurers in 2018, emphasized the need to simplify prior authorization requirements, reduce the administrative burden on healthcare providers, and prioritize timely access to care for patients. Cigna and UHC's recent actions are aligned with these principles and indicate a commitment to improving the healthcare experience for all stakeholders.
While this shift is certainly promising, it's important to maintain a degree of caution. The complete elimination of prior authorization is unlikely, as insurance companies will continue to prioritize cost management and appropriate care. However, the willingness of major insurers like Cigna and UHC to reevaluate and refine their prior authorization processes is a step in the right direction.
In conclusion, the decision by Cigna and UHC to reduce prior authorization requirements for numerous procedure codes is a welcome development in the healthcare industry. It reflects a growing awareness of the need to streamline processes, reduce administrative burdens, and prioritize timely access to care. While challenges may still exist, this move demonstrates a commitment to improving the healthcare experience for patients and providers, in line with the consensus statement's objectives.
Learn more about UHC's modified process for GI services here.