By Mukundan Sivaraj · AIM Media House
A patient waits. A treatment has been ordered, but before it can happen, the provider needs approval from the insurer. That process, prior authorization, can take days or weeks depending on the case.
Nearly 95% of physicians say it delays access to necessary care, according to the American Medical Association's 2025 survey. Anand Biradar, chief GTM strategy & enterprise transformation officer at Sagility, has spent two decades in healthcare operations.
"Sometimes PAs can take a week, two weeks[,] or sometimes even more, depending on the case," Biradar said to AIM Media House . AI is now being tested across the industry to speed that process up. Prior authorization remains, in his view, the hardest piece of the puzzle to solve. Here's why.
What Prior Authorization Actually Involves Prior authorization is tied to the specifics of a person's health plan. An employer negotiates coverage terms with an insurer, and depending on the plan, certain procedures require sign-off before a provider can deliver them.
If a service falls into that bucket, the hospital or clinic has to secure approval first. "[Prior authorization] is really to avoid unnecessary waste of procedures," Biradar said. The burden this creates is significant.
Physicians complete an average of 40 prior authorization requests per week, and 32% say those requests are often or always denied, per the AMA survey . Nearly 79% report that patients abandon treatment altogether because of the delays.
This is the point in the healthcare system where administrative process and patient outcomes meet directly. Why AI Hasn't Solved It Enterprise AI adoption broadly has struggled to move past pilot stage.
Research from MIT's NANDA initiative found that 95% of generative AI pilots across industries failed to produce measurable financial impact, largely because tools weren't built to adapt to real organizational workflows.
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