UnitedHealthcare cutting prior authorizations by another 30%
UnitedHealthcare is working to reduce prior authorizations to help improve speed to care and ease administrative complexity.
- UnitedHealthcare will eliminate an additional 30% of prior authorization requirements by end of 2026
- Through initiatives like the Gold Card Program and a collaborative effort with AHIP and other health insurers, UnitedHealthcare is streamlining the prior authorization process to reduce administrative work for providers and ensure members receive timely access to the care they need.
- Eliminating steps in the care journey may improve overall employees’ satisfaction with their health plan.
- Today, 98% of claims do not require prior authorization review,4 and UnitedHealthcare's continued investments in standardization, automation and interoperability reflect the organization's commitment to making health care simpler and more efficient, while also reducing waste and unnecessary spending.
While prior authorizations are an important checkpoint to ensure a service or procedure is safe, medically appropriate and cost-effective, UnitedHealthcare understands that they can be a pain point for both members and care providers, especially if they are flagged for further review.
That’s why UnitedHealthcare continues to evaluate and take steps to speed up, reduce or even eliminate prior authorizations where appropriate — and be more transparent along the way by making its efforts and approval rates publicly available via uhc.com/PAmadeclear. This also includes enlisting third-party reviews of its core business practices and processes, and publishing report findings and progress as improvements are made.
Most recently, in April 2026, UnitedHealthcare announced that it will be eliminating prior authorization requirements for 30% of services that previously required insurer approval, including for select outpatient surgeries, diagnostic tests like echocardiograms, and certain outpatient therapies and chiropractic care.
“Prior authorization is an essential safeguard but should only be used when it truly protects patients and improves care,” says UnitedHealthcare CEO Tim Noel. “Eliminating these requirements is one more way we are working to make it easier for patients to get the care they need when they need it and ensure doctors can spend more time with their patients. We are committed to further improving and refining our processes to make reviews quicker, simpler and more efficient.”
This builds upon UnitedHealthcare’s work with the Gold Card Program, which recognizes and awards provider groups who consistently adhere to evidence-based care guidelines by reducing their total prior authorization requirements across hundreds of codes, impacting many specialties including primary care, orthopedics, cardiology, oncology and more.
70%
of UnitedHealthcare prior authorizations will be part of the new standardized submission process by end of 2026
Instead of submitting formal prior authorizations, these qualifying provider groups only need to follow a simple administrative notification process for most procedure codes. This helps to remove some of the administrative work for providers, allowing them to spend more time with their patients, which may lead them to deliver a higher quality of care and better health outcomes as a result.1
In 2025, the Gold Card Program reduced the volume of prior authorization requests by an average of 30% for eligible provider groups.2 By the end of 2026, more than 70% of UnitedHealthcare’s prior authorizations will be part of a new standardized submission process by year-end, enabling greater automation and interoperability for care providers and patients alike.
UnitedHealthcare also teamed up with America’s Health Insurance Plans (AHIP) and other health insurance companies to further these efforts at an industry level. These shared commitments, which are projected to benefit 257M Americans,3 include:
- Standardizing electronic prior authorizations
- Reducing the scope of claims that are subject to prior authorization
- Ensuring continuity of care when patients change plans
- Enhancing communication and transparency on prior authorization determinations
- Ensuring medical review of non-approved requests
- Expanding real-time responses, with the goal that at least 80% of electronic prior authorization approvals in 2027 will be answered in real-time (as long as they include all necessary clinical documentation)
Today, for Employer and Individual plans, UnitedHealthcare does not require a prior authorization review 97.9% of the time.4 Of the remaining 2.1% of claims that did require prior authorization,4 almost 9 in 10 were ultimately approved,5 most within less than 24 hours.6 Plus, many non-approvals occur due to claims having missing, incomplete or inaccurate information.
How this impact employers
By streamlining the prior authorization process for members and providers, employees may be able to receive the care they need more quickly and without delay due to administrative processes. As a result, employers may not receive as many questions or complaints from their employees, and overall employee satisfaction with their health plan may improve.
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