BCBS Michigan to cut 20% of prior authorization requirements

Blue Cross Blue Shield of Michigan is the latest payer to announce it is scaling back its prior authorization requirements.

BCBS Michigan is cutting approximately 20 percent of its prior authorization requirements and expanding its gold-card program, according to a Sept. 7 news release from the insurer. 

A BCBS Michigan spokesperson told Becker's the process has begun and it will be a phased rollout. 

Technology has helped the payer accelerate the prior authorization process, with a majority of requests submitted electronically, according to the release. It processes about 87 million claims annually, and about 2.5 million go through the review system. 

"Most prior authorization requests are submitted electronically and approved within seconds using automation that expedites the process," Jeniene Edwards, RN, BCBS Michigan's vice president of utilization management, said in the release. "Our goal is to leverage multiple channels of technology for transparency and automation, which also enables us to accelerate decisions to minimize disruption to our members."

BCBS Michigan joins other payers that have recently announced prior authorization cuts. UnitedHealthcare on Sept. 1 initiated the first of two waves that will cut 20 percent of its requirements. Cigna Healthcare said Aug. 24 that it has removed prior authorization requirements for more than 600 medical procedures, cutting the number it requires by 25 percent. 

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