I work for an insurance company that has offered early retirement and layoffs will be next. Can anyone with reliable knowledge please share if United uses AI for prior authorization reviews? And if so, were nurses laid off as a result? Thank you so much.
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Prior Authorization Automation
A 2024 Senate Permanent Subcommittee on Investigations report found that UHC, along with Humana and CVS, used machine-assisted prior authorization tools—effectively AI—to review and decide on post-acute care authorizations.
Between 2019 and 2022, UnitedHealthcare’s denial rate for post-acute services surged—from 8.7% to 22.7%, and particularly spiked for skilled nursing facilities.
@14z what other choice do we have? We are not being given any information. The latest news about he’s in the requirements for prior authorization request. It’s very troubling. It is good for the members, but what does that mean for us?
They are developing OCM which is an automated platform to do all reviews. Once it is operational it will only require about 50 people (nurses) to do the work of 1200 .
@OP that's too funny, I'm over here trolling too. You sound like you may work in my department too. How funny.
I don't know which insurance company you work for, and I am not a nurse but I have been through a VRSP and then a massive layoff. Thankfully, I was spared. I will tell you to tread carefully. If you accept a VRSP (a volunteer severance program), please be aware that if they contact you during the time you accept the severance, and offer you the same or a similar position, you may lose your severance if you decline. Please check your agreement before you sign it. You may actually want to look at having an attorney look at your agreement to make sure you will not be in that position. Also, depending on which state you live in, you may not be eligible for unemployment benefits once your severance runs out. Some states do allow this while others do not. Just give it some serious thought before you make any decision as each has its' own challenges..
You must be living in an alternative universe where some employers are isolated from the economic, technological, and political turbulence of 2025.
United is a dumpster fire right now.....steer clear.