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AI: Friend or Foe in Medical Approval?

Is AI making healthcare approvals too smart for its own good—or just too slow?

Personal stories of battling insurance red tape are all too common, with prior authorization serving as a bureaucratic hurdle. While it aims to prevent overuse and inefficiency, this process can delay necessary care, frustrating both patients and doctors.


Enter artificial intelligence (AI): capable of processing vast amounts of data to potentially speed up approvals for clear-cut cases. Yet, concerns abound that AI might unfairly deny valid claims. A 2025 survey by the American Medical Association found that 61% of physicians fear AI will make their patients’ struggles worse.


To address these worries, the AMA calls for insurers to provide detailed explanations for denials and increase transparency around algorithms.


The Trump administration is testing an AI-driven approach in six states to curb unnecessary spending, but its impact remains uncertain. Will AI streamline approvals or add more layers of complexity?

Original source:  https://arstechnica.com/ai/2026/07/will-ai-fix-prior-authorization-or-make-it-worse/
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