In recent years, doctors and patients have reported serious frustration with requirements from insurers for prior authorization before a laundry list of medical treatments and procedures can take place.

In a June survey by the American Medical Association, 90% of physicians reported that the sometimes arduous process negatively affects outcomes for their patients, and nearly one in four doctors said prior authorizations “led to a serious adverse effect” for at least one of their patients. A widely reported study by the health policy research nonprofit KFF found the practice widespread among Medicare Advantage insurers, with an average of 1.7 prior authorization requests submitted per Medicare Advantage enrollee in 2022—a total of 46 million requests.

Prior authorization requirements can also be time-consuming for doctors and medical facilities, which need to document their patients’ need for specific care. Medical providers sometimes must engage in lengthy fax and phone correspondence with insurers before treatment begins, taking time and resources away from actual medical care.

Research has shown that the vast majority of prior authorization requests—including more than 92% of those examined in the KFF report—are ultimately approved by insurers. But these still come at a cost for patients who experience treatment delays, doctors who need to work with health plans to see treatment authorized, and insurers themselves, who typically employ nurses and doctors to review those treatment requests.

A startup called Anterior looks to make the process smoother, deploying artificial intelligence technology to help frontline employees at insurance companies review prior authorization........

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