Independence Blue Cross turns national prior authorization commitment into tangible results

Prior authorization reduced by 14%

Independence Blue Cross (IBX) has put a prior authorization commitment into action - delivering faster, more direct access to appropriate treatments and medical services for members. Since joining the national effort to simplify prior authorization and improve the process last year, IBX has focused clinical reviews on more complex cases, streamlined work with doctors, and expanded digital platforms for many requests.

These actions are producing measurable results. From 2024 to 2025, IBX reduced prior authorization by 14 percent. That eliminated the need for nearly 140,000 prior authorizations, easing access to care for IBX members and their providers.

"Prior authorization is important for member safety and quality, and also to ensure services are administered according to the member's benefits; and it is most effective when it's targeted and clinically led," said Dr. Richard L. Snyder, executive vice president and chief operating officer of Independence Blue Cross. "By limiting clinical reviews to only the cases that truly need them and automatically approving routine requests, we've cut out unnecessary steps and helped patients get to care faster. And we were able to do all of this and keep strong safety, quality, and medical standards in place."

IBX turns commitment into action:

• Standardizing digital submissions. IBX now handles more than 80 percent of prior authorization requests electronically and 66 percent are approved real time after an automated review.
• Improving transparency and communication. To help members and doctors better understand prior authorization decisions, decision notices are clearer and easier to understand and customer service and care teams have more training to help members and providers when questions come up.
• Helping members maintain care when they change health plans. IBX supports a 90-day continuity of care period and is implementing a more automated, system-wide approach.
• Ensuring clinician-led reviews. Reviews are conducted by qualified clinicians and only licensed medical professionals can issue denials.

IBX's ongoing commitment

IBX's streamlining of prior authorization began prior to last year's national commitment. In 2023, IBX launched a Utilization Management Simplification Program with Penn Medicine that has delivered meaningful results. The program was expanded to Temple Health and Abington Medical Specialists, with more providers joining soon.

Media Contact:
Grant Gegwich
610-909-3937
[email protected]