The Evolution of Prior Authorization: From 2005 to AI Solutions

This chapter explores the transformation of the prior authorization process in healthcare, highlighting its shift from a clinical interaction in 2005 to a more automated system by 2023. It discusses the challenges posed by reduced human interaction and the rising volume of authorizations, while emphasizing the potential of artificial intelligence to enhance efficiency and decision-making. The conversation also touches on the importance of balancing automation with patient care to improve experiences and outcomes for both providers and patients.