Prior authorizations (PAs) continue to be one of the biggest hurdles to timely patient care. A recent survey found that 93% of physicians say that the PA process can delay treatment and three-quarters have seen PAs increase over the last five years.
During a recent Becker’s Healthcare webinar, Mike Cohn, Vice President of Network Operations at CoverMyMeds, shared how automation and AI can be used to help streamline the PA process, so patients can access the medications they need without unnecessary delays.
Three key takeaways were:
- PAs are both a people and a process challenge. Traditional PA workflows are time-consuming and often require manual steps that contribute to burnout, staffing challenges and frustration across care teams. For specialty medications, the process can be even more complex, sometimes requiring both pharmacy and medical PAs.
Patients feel the impact too. Waiting days, or even weeks, for approval can lead to missed doses or abandoned treatment. As highlighted in the 2025 CoverMyMeds Medication Access Report, 1 in 5 physicians say PA issues have caused patients to walk away from their medications. 1
“This isn’t just about paperwork,” Mike noted. “It’s about making sure people don’t fall through the cracks.”
Electronic prior authorization (ePA) is helping shift that dynamic. By automating key steps, ePA reduces manual work and helps care teams get decisions back more quickly. Typically, PA approvals via fax or phone take around 17 hours. With ePA, decisions are often returned in approximately five hours, and in many cases, even sooner.2
“There are a lot of problems to solve with traditional prior authorization. The good news is that tools like electronic prior authorization, or ePA, can help automate the process, reduce manual workload and speed decisions. And when providers have access to ePA tools inside their workflow, they’re more likely to submit requests right away,” as Mike shared.
- A strategic approach to PA positively impacts care delivery and the bottom line.
PA affects more than just medication access; it can have real implications for care delivery and financial performance. When systems like EHRs, payer portals and pharmacy platforms operate in silos, it creates delays and denials that can slow down reimbursements and lead to costly write-offs.
Health systems that take a more strategic approach are starting to see meaningful improvements. By integrating technology into existing workflows, they’re turning PA from a pain point into a more coordinated part of the care process.
Specialty care teams are using automation to align benefit verification, PA and financial assistance identification. This kind of sequencing helps reduce fragmentation and keeps care moving forward, allowing providers more time to focus more on their patients.
- Responsible, scalable AI deployment keeps humans in the loop and focuses on compliance.
AI and automation can help improve the PA process, but they’re not a substitute for clinical expertise. For complex therapies, especially, human oversight remains essential.
A responsible approach to AI starts with strong governance. That means involving the right stakeholders early, setting clear guardrails and testing solutions before scaling them across an organization.
When done right, AI can support care teams by streamlining workflows and helping them make timely, informed decisions. As Mike shared, “If you bring the right stakeholders in upstream and do the due diligence, you can execute with velocity and peace of mind downstream to drive real impact.”
The goal isn’t just to deploy technology, it’s to do so in a way that improves care and maintains trust. Keeping patients at the center of every decision is critical. That’s what drives impact and ensures that innovation supports, rather than disrupts, the delivery of care.
To learn more, check out the full webinar, here.
1 CoverMyMeds Data on File, 2023.
2 Based on review of October 2023 ePA vs traditional prior authorization submissions.
