Prior Authorization Automation Requires More Than Just a New Interface

X12 Blog August 17, 2026 Prior Authorization Automation Requires More Than Just a New Interface Prior authorization remains one of the most visible, widespread, administratively frustrating, and costly challenges in the U.S. healthcare system. Prior authorization, defined as the process by which payers determine the medical necessity of specific procedures before allowing clinicians to provide the service, is estimated to account for $35 billion of U.S.