The Administrative Burden
Prior authorizations were originally designed to control healthcare costs and ensure appropriate care. But today, the hidden cost of prior authorizations is taking a serious toll on providers—delaying treatment, draining resources, and contributing to burnout. Manual processes demand a disproportionate amount of staff time, requiring repeated follow-ups for a task that isn’t even clinical.
Key Stats
- 14.6 hours/week per physician spent on PA-related tasks (American Medical Association)
- 40 minutes average per PA request, with some taking several hours
- Up to 6 different touchpoints may be involved (nurse, coordinator, pharmacist, physician, billing)
Impact
- Clinician burnout from administrative overload
- Delays in treatment as patients wait for approvals
- Decreased patient satisfaction due to scheduling and access issues
- Workflow disruption as staff toggle between EHRs, payer portals, fax machines, and phones
The hidden cost of prior authorizations isn’t always financial—it’s measured in stress, staff hours, and burnout.
“The amount of time our nurses spend just chasing paperwork is staggering. It takes away from care—and from their job satisfaction.”
The Financial Toll
Direct Costs
- Labor: Salaries for prior auth coordinators, nurses, and admin staff dedicated to PA work
- Technology: Multiple vendor systems, fax machines, portals—not integrated, not efficient
- Training: Constant onboarding due to PA rules changing by payer, drug, or procedure
Indirect Costs
- Productivity loss: Providers and nurses pulled away from revenue-generating or patient-facing activities
- Delayed revenue: Unsubmitted or denied PAs lead to missed appointments or rescheduled procedures
- Denials and rework: Rejected PAs often require appeals or re-submissions, doubling the workload
Industry Estimate
- $13.29 to $99.56 per manual PA (CAQH 2023 Index)
- A typical mid-size clinic processes hundreds to thousands of PAs per month
- That translates into tens of thousands of dollars per year—spent just on paperwork
Downstream Consequences
- Treatment abandonment: ~30% of patients abandon treatment when faced with PA delays
- Worsening outcomes: Delays in medications or diagnostics can escalate conditions
- Staff turnover: Administrative load is a top contributor to burnout and attrition, especially among nurses and care coordinators
The Inefficiency Cycle
Manual PAs often result in a “denial-repeat” loop:
- Request submitted with missing or incomplete documentation
- Payer denies or requests more information
- Staff restarts the process
- Delays mount, and productivity stalls
This cycle costs more than just time—it degrades the provider-patient relationship and undermines trust in the system. Understanding the hidden cost of prior authorizations can help payers and policymakers reform the system. Discover how Karova’s AI-powered system outperforms manual PA workflows.
How the Hidden Cost of Prior Authorizations Impacts Care Teams
Karova Health is built to eliminate these pain points by:
- Automating clinical data extraction
- Filling out and validating PAs instantly
- Reducing denials through payer-specific logic
- Restoring clinical time to where it belongs—on patient care
Final Thought
Manual prior authorizations aren’t just an inconvenience—they’re a financial liability and clinical risk. For providers already stretched thin, the only sustainable solution is intelligent automation. Karova helps practices reclaim time, revenue, and peace of mind. The hidden cost of prior authorizations doesn’t need to be inevitable. See how Karova Health helps providers reclaim their time—and protect their patients.
