Prior authorization fax loops delay MRI approvals by 14+ days

Most health insurers still require prior authorization requests for advanced imaging (MRIs, CT scans) to be submitted via fax, which then cycle through 2-3 internal review queues before a determination is made. This means a patient with suspected torn ACL waits two weeks in pain before they can even get the scan that confirms whether they need surgery, turning a 4-week recovery timeline into 6+ weeks. The delay exists because insurers built their utilization management systems in the 1990s around fax-based workflows, and re-platforming would require retraining thousands of nurse reviewers and rewriting contracts with delegated review vendors. The AMA reports that 94% of physicians experience care delays due to prior auth, but no single insurer has incentive to modernize unilaterally because slow approvals reduce short-term claim payouts.