{"id":284087,"date":"2026-04-24T17:44:17","date_gmt":"2026-04-24T17:44:17","guid":{"rendered":"https:\/\/www.newsbeep.com\/us-ca\/284087\/"},"modified":"2026-04-24T17:44:17","modified_gmt":"2026-04-24T17:44:17","slug":"blue-shield-of-california-joins-latest-industry-effort-to-simplify-prior-authorization-blue-shield-of-california","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/us-ca\/284087\/","title":{"rendered":"Blue Shield of California Joins Latest Industry Effort to Simplify Prior Authorization | Blue Shield of California"},"content":{"rendered":"

\"GettyImages-2205708759\"<\/p>\n

Today,\u00a0AHIP\u00a0(formerly America’s Health Insurance Plans) and Blue Cross Blue Shield Association announced a new, voluntary effort<\/a> by leading health plans\u00a0to\u00a0make prior authorization easier and more consistent. The\u00a0initiative is designed\u00a0to help care teams know\u00a0exactly\u00a0what information is needed\u00a0the first time\u00a0they\u00a0submit\u00a0requests for common services like\u00a0hip replacement, knee replacement, and CT scans.\u00a0Blue Shield of California is one of\u00a0more than 50\u00a0participating plans and will\u00a0make these changes\u00a0beginning January 1,\u00a02027.\u00a0<\/p>\n

\u201cPatients\u00a0can\u00a0experience\u00a0unnecessary\u00a0delays in care simply because\u00a0requirements aren\u2019t always\u00a0made\u00a0clear up front,\u201d said Frank Caporusso, senior vice president of Healthcare Quality and Affordability Operations at Blue Shield of California. \u201cThis commitment\u00a0helps\u00a0set clearer, more consistent\u00a0expectations so providers can submit the right information the first time, and patients\u00a0can get the care they need more quickly.\u201d\u00a0\u00a0<\/p>\n

The announcement builds on recent industry progress.\u00a0\u00a0<\/p>\n

Earlier this month,\u00a0AHIP and\u00a0Blue Shield of California\u00a0shared new data<\/a>\u00a0showing that health plans across the country are reducing how often prior authorization is\u00a0required,\u00a0resulting in\u00a06.5\u00a0million fewer requests\u00a0nationwide\u00a0and faster access to care.\u00a0This latest step focuses on improving the experience for the remaining prior authorizations that are still clinically\u00a0appropriate.\u00a0<\/p>\n

\u201cThis\u00a0commitment shows that the industry is serious about how prior authorization affects people\u2019s care experience,\u201d Caporusso said. \u201cThe work ahead is about making the\u00a0process clearer and more dependable for patients and providers.\u201d\u00a0<\/p>\n

The AHIP\u00a0announcement\u00a0aligns with\u00a0Blue Shield of California\u2019s broader Prior Authorization Reimagined effort, launched in 2024, to\u00a0modernize\u00a0the prior authorization process,\u00a0increase real-time and automated decisions, and make\u00a0expectations\u00a0clearer and more predictable for care teams.\u00a0<\/p>\n

For more information\u00a0about Blue Shield of California\u2019s\u00a0work\u00a0to\u00a0simplify\u00a0prior authorization, visit\u00a0our\u00a0Prior Authorization Reimagined<\/a>\u00a0page.\u00a0<\/p>\n","protected":false},"excerpt":{"rendered":"Today,\u00a0AHIP\u00a0(formerly America’s Health Insurance Plans) and Blue Cross Blue Shield Association announced a new, voluntary effort by leading…\n","protected":false},"author":2,"featured_media":284088,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[6],"tags":[7,9,8],"class_list":{"0":"post-284087","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-california","8":"tag-california","9":"tag-california-headlines","10":"tag-california-news"},"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/posts\/284087","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/comments?post=284087"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/posts\/284087\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/media\/284088"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/media?parent=284087"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/categories?post=284087"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/tags?post=284087"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}