05/06/2026
Insurers are making progress in standardizing how they vet requests for medical treatments and services, the latest in a series of commitments meant to reduce paperwork and make it easier for patients to access care.
Major insurers led by AHIP and the Blue Cross Blue Shield Association announced on Friday that electronic data submission requirements will align for medical services commonly subjected to prior authorization, including orthopedic surgeries, CT scans and MRIs, beginning Jan 1.
Additionally, prior authorizations will be standard across commercial plans like Medicare and Medicaid, with more services being added over time.
aequum can help as these standards come into play, ready to navigate the transitions by using specialty expertise to ensure all submissions meet the new criteria, minimizing denials and accelerating patient care.
Learn more: https://ow.ly/6Zcz50YUBZV
Aligning electronic data submission requirements for prior authorizations is one prong of the insurance industry’s commitment to reform the unpopular preapprovals.