Physicians warn AI is driving up prior authorization denials

Becker's Healthcare March 10, 2025
Francesca Mathewes

The implementation of AI has become widespread in healthcare, but physicians are concerned that unregulated AI use is increasing prior authorization denials, according to a May 7 report by the American Medical Association.

Here are five notes on physicians’ growing concern about AI use in prior authorization:

1. In a recently released AMA survey, 61% of physicians said they feared that payers’ use of unregulated AI was creating more prior authorization denials, which can cause delays in treatment and harm patients.

2. “Emerging evidence shows that insurers use automated decision-making systems to create systematic batch denials with little or no human review, placing barriers between patients and necessary...

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