Follow the rules. Understand the workflow. Protect access to care.
Source-backed reporting and analysis connected to the companies, capabilities, authorities, and operating domains it affects.
Aetna's 84-page 2025 disclosure presents medical-service prior-authorization percentages by Medicare Advantage contract. Any multi-contract result must name its contract roster, aggregation question, compatible weight for every included value, missing-data rule, and calculation version; the PDF does not provide request counts for a volume-weighted payer total.
UnitedHealthcare publishes plan-specific advance-notification and prior-authorization resources and directs professionals to check by member in its portal for the most accurate response and a Decision ID. Operations teams need to preserve which plan, service, effective-date file, and member-specific result governed each request.
Humana's 2025 report for Medicare Advantage contract H4461 shows a zero-day median alongside a one-day mean for standard requests and a zero-hour median alongside a five-hour mean for expedited requests. A median describes the middle observation—not every case or a service commitment.
Cigna's provider page assigns different purposes, requirements, channels, and decision limits to three related workflows. Treating them as one authorization status loses the payer and provider responsibilities that control the request.
The March 31 reporting milestone creates a new, imperfect public evidence layer for examining payer authorization volume, outcomes, and decision timeframes.
The initial Decision Intelligence Ecosystem connects Anterior, Latitude Health, and Case Health AI to GuidingCare, signaling a modular market for clinical review intelligence.
The provider-side offering combines rules, payer connectivity, automation, EHR completion, and human operations across determination, submission, and follow-up.
The payer committed to removing about one-third of outpatient prior-authorization requirements, expanding one-day decisions, and launching a national gold-card program.
