Humana to reduce prior authorizations, streamline care approval process

Published 22/07/2025, 11:14
Humana to reduce prior authorizations, streamline care approval process

Investing.com -- Humana (NYSE:HUM) is taking steps to speed up care request approvals and reduce administrative burdens for physicians related to prior authorization requirements.

The health insurer plans to eliminate approximately one-third of prior authorizations for outpatient services by January 1, 2026. This includes removing authorization requirements for diagnostic services such as colonoscopies, transthoracic echocardiograms, and select CT scans and MRIs.

Humana has also committed to providing decisions within one business day on at least 95% of all complete electronic prior authorization requests by January 1, 2026.

The company will launch a new gold card program in 2026 that waives prior authorization requirements for certain items and services for providers who have demonstrated a proven record of submitting coverage requests that meet medical criteria.

Additionally, Humana plans to publicly report its prior authorization metrics in 2026. These metrics will include requests approved, denied and approved after appeal, as well as the average time between submission and decision.

This article was generated with the support of AI and reviewed by an editor. For more information see our T&C.

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