Will AI fix prior authorization—or make it worse?

Ars Technica · 2 months ago · 27

AI is being explored to expedite prior authorization decisions in healthcare by processing large volumes of information, but a 2025 American Medical Association survey found 61 percent of physicians worried that AI tools will increase wrongful denials of medically necessary treatments. The technology could reduce care delays for straightforward approvals but faces resistance due to concerns about increased coverage denials. If AI is implemented poorly, it could worsen patient outcomes rather than improve the authorization process.