How To Speed Up The Prior Authorization Process

The Prior Authorization Challenge

Prior authorization (PA) is one of the most frustrating bottlenecks in healthcare administration. Studies show that medical practices complete an average of 41 prior authorizations per physician per week, consuming approximately 16 hours of staff time. 94% of physicians report that PA delays patient care, and 80% say it can lead to treatment abandonment.

Why Prior Authorizations Are Necessary

Insurance companies require prior authorization to ensure that a proposed treatment or procedure is medically necessary and covered under the patient’s plan. While the intent is cost control and clinical appropriateness, the process often becomes a barrier to timely care and a source of administrative overhead for providers.

Strategies to Accelerate Prior Authorization

1. Know Your Payers’ Requirements

Create a comprehensive reference guide for each major payer’s authorization requirements. Knowing exactly which services require authorization, what documentation is needed, and the preferred submission method can eliminate unnecessary back-and-forth and reduce processing time significantly.

2. Leverage Electronic Prior Authorization (ePA)

Electronic prior authorization platforms streamline the process by enabling digital submission, automated status tracking, and real-time decision support. ePA can reduce authorization turnaround time from days to hours, and in some cases, even minutes for automated determinations.

3. Submit Complete Documentation the First Time

Incomplete submissions are the primary cause of PA delays. Develop a checklist for each common authorization type that includes all required clinical notes, test results, and supporting documentation. A complete first submission dramatically improves approval rates and reduces turnaround time.

4. Track and Follow Up Systematically

Implement a tracking system that monitors the status of every pending authorization and triggers follow-up actions at defined intervals. Don’t wait for payers to respond—proactive follow-up can significantly reduce approval timelines and ensure no authorizations fall through the cracks.

5. Outsource to Specialists

For many practices, the most effective solution is to outsource prior authorization management to a specialized RCM provider. GoBill’s pre-authorization team handles the entire process—from verifying requirements and submitting requests to tracking status and expediting approvals. Our clients see authorization processing times reduced by up to 60%.

The Bottom Line

Prior authorization doesn’t have to be a bottleneck. With the right processes, technology, and expertise, you can significantly speed up the PA process, reduce administrative burden, and ensure patients receive the care they need without unnecessary delays.