Blue Shield California is partnering with cloud-based software company Salesforce to automate prior authorization requests, intending to fast-track decisions from days to “near real time,” according to a press release. Starting in 2025, the pair will test artificial intelligence (AI) technology that can scan a patient’s electronic health record, automatically pull health information that is relevant to a request, then put it into a form that can return a prior authorization decision within minutes, according to the October 21 release. The tech will have a limited rollout later in the year and officially be available in January 2026. “Prior authorization was never meant to be a barrier or a burden. As a health plan, it’s our responsibility to ensure safe, evidence-based, high-value care for our members, and we know it can be an easier process for everyone,” Paul Markovich, CEO of Blue Shield California, said in the release. A growing problem. Prior authorization has long been a source of stress for healthcare providers. Physicians say the process takes an average of 12 hours a week, delays care, hurts patient outcomes, and ends in unjust denials, according to the American Medical Association’s annual 2023 prior authorization physician survey. It also found that 95% of respondents report prior authorization increases burnout. Keep reading here.—CC |