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Prior authorizations consume 14 staff hours each week. We mapped every minute.

We spoke to dozens of small practices across the US. This is what we heard.

45 min
Average time per PA request
AMA Prior Auth Survey 2024
35%
Of PA requests initially denied
AMA Physician Survey 2024
88%
Of physicians say PA delays necessary care
AMA Prior Auth Survey 2024
Scroll to see the full empathy timeline ↓
Medical staff overwhelmed by prior authorization paperwork
SECTION 2 / THE CURRENT WORKFLOW TIMELINE

A single prior authorization request, step by step, in today's workflow.

Follow one PA request for a brain MRI through a 20-person orthopedic clinic. Eight steps. Three to five systems. Forty-five minutes of active work.

Manual / painful step
Waiting / delay
Neutral step
0 min
Order is placed
Provider places an order for imaging, procedure, or medication in the EHR.
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This is the only step that happens inside the EHR. Everything after this leaves the clinical workflow and enters the administrative maze.
+5–10 min
Check if PA is required
Staff logs into the payer's portal or calls to check whether this specific service needs prior authorization for this patient's plan.
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Every payer has a different portal. Some require a phone call. Staff often checks 2-3 places to be sure.
UHC Aetna BCBS Cigna Humana ?
+5–8 min
Find the right form
Staff hunts for the correct PA form — which varies by payer, plan type, state, and service category.
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UnitedHealthcare alone has different forms for each state. Anthem has separate forms for medical vs. behavioral health. There is no universal PA form.
+10–15 min
Gather clinical documentation
Staff opens the EHR in a separate window, locates diagnoses, medications, labs, and clinical notes. Then manually copies or re-types this into the payer's form.
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This is where most time is lost. Staff toggles between 2-4 windows: EHR, payer portal, the PDF form, and sometimes a fax cover sheet. Copy-paste is the primary integration method.
EHR
Portal
PDF
+5 min
Submit the request
Staff submits via payer portal, fax, or phone. The channel depends on the payer — some still only accept fax for certain services.
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Fax is still used for approximately 25% of PA submissions nationally.
🖥
?
📠
?
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+1–14 days
Wait for a response
The request enters a black hole. Staff has zero visibility. Average turnaround is 2-5 business days, but can stretch to two weeks.
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During this time, the patient's procedure is on hold. Staff may call the payer for status updates, waiting on hold 15-30 minutes each time.
Pending...
+15–30 min (if triggered)
Handle additional info requests or denial
35% of the time, the payer responds with a denial or request for more information. Staff goes back into the EHR, finds missing docs, and resubmits.
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Peer-to-peer reviews require scheduling a call between the ordering provider and the payer's medical director — which alone can take days to coordinate.
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Total: ~45 min + 1–14 days
Approval received (finally)
PA is approved. Staff records the auth number in the EHR and notifies scheduling that the procedure can go ahead.
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By this point, the staff member has touched 3-5 different systems, made multiple calls, and the patient has waited days for care they'll almost certainly be approved for.
PHASE REALITY / 5 CONTEXT SWITCHES

One patient request splinters across five systems before anyone can close the loop.

A coordinator answers the call, opens the queue, switches to the payer portal, toggles the EHR, verifies the fax — then starts billing. Each handoff forces a context switch that drains focus and creates error risk.

01
PHONE TRIAGE
Staff calls the payer's toll-free line to confirm PA requirements or check status.
02
FAX HANDOFF
Documents faxed to the payer because their portal doesn't accept electronic uploads for this service.
03
PORTAL VERIFICATION
Staff logs into the payer's provider portal to look up requirements and submit electronically.
04
EHR RECONCILIATION
Staff switches back to the EHR to pull clinical data and record authorization numbers.
05
BILLING FOLLOW-UP
Billing staff verifies the auth number matches the claim before submitting for payment.
"Four switches before resolution. Every boundary drains momentum."

This isn't a process. It's an endurance test — for your staff, your providers, and your patients.

Multiply that by 15-20 requests per day.

The cumulative load on a small clinic's staff is staggering. And the financial and patient impact is measurable.

0
Staff time spent on PA
That's one full-time employee doing nothing but prior auth paperwork
0
Administrative cost per request
For a practice processing 80 PAs/month, that's $2,500/month in admin cost alone
CAQH Index 2024
0
Of PAs are eventually approved
Most of this work is a formality — not genuine clinical gatekeeping
0
Of patients report PA caused care delays
Delayed imaging. Delayed surgeries. Delayed medications.

What if 80% of this disappeared?

What if an intelligent assistant could detect the order, check the requirement, pull the clinical data, fill the form, submit it to the right place — and only come to you when it actually needs a human?

See how it works →