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What prior authorization costs a medical practice in staff time.

A practice with 6 physicians doing the AMA’s average of 40 prior authorizations a week each spends about 4,368 staff hours a year on them. At a loaded medical-records wage, that comes to $140,000.

Jeff Weinberg, JRW · Updated 22 October 2026

Your staff spend about 4,368 hours ($139,632) a year on 240 prior authorizations a week, at 16 minutes each with 25% denied or sent back. An agent that takes over 70% of the hands-on work gives back about 2,434 hours ($77,795) a year.

$139,632 Staff cost of prior authorizations, per year
  • Staff hours, per year: 4,368
  • Hours per physician, per week: 14
  • Full-time staff it takes: 2.1
  • Of those, hours on denials and resubmissions: 1,040
  • Cost per prior authorization: $11.19
  • Hours back with an agent, per year: 2,434
  • Staff cost back with an agent, per year: $77,795

How the number is worked out.

The model counts hands-on staff minutes: assembling the request, submitting it, chasing it, and doing it again when it is denied. Physician time, patient delays and abandoned care are real costs it leaves out.

  1. 01Requests a year. Physicians times requests per physician per week times 52. The AMA’s 2025 survey of 1,000 physicians puts the average at 40 a week, prescriptions included. The 2024 survey found 39.
  2. 02Minutes each. CAQH measured 24 minutes for a request by phone, fax or email and 16 by portal. The default uses the portal figure. With rework added it lines up with the AMA’s 13 hours a week per physician.
  3. 03Rework. Nearly a third of physicians told the AMA that requests are often or always denied. The default sends a quarter of requests around again at 20 minutes each.
  4. 04What the time costs. Hours times the hourly wage of the staff doing it, plus 30% for benefits and overhead. The wage default is the federal median for medical records specialists.
  5. 05What automation leaves. An agent that assembles the request from the chart, submits it through the payer’s channel and chases it takes over most of the hands-on minutes. A person still reviews each one, and the model counts those minutes.

The defaults.

Dials you change are marked in colour. The last column says where each default comes from and what kind of source it is.

DialYoursDefaultWhere the default comes from
Physicians66JRW, 2026 Our default
Prior authorizations per physician per week4040American Medical Association, 2025 Survey
Staff minutes per request1616CAQH, 2024 Survey
Requests denied or sent back25%25%JRW, anchored on the AMA, 2026 Our default
Minutes per denial or resubmission2020JRW, 2026 Our default
Hourly wage of the staff doing it$25$25US Bureau of Labor Statistics, Occupational Outlook Handbook, 2025 Official
Benefits and overhead on top30%30%JRW, 2026 Our default
Hands-on time an agent takes over70%70%JRW, 2026 Our default
Human review per item after automation33JRW, 2026 Our default

Sources.

Two primary sources carry the defaults: the AMA’s annual physician survey and CAQH’s index of administrative transaction costs, from plan and provider data for 2023.

Our defaults. We put the agent’s share of hands-on time at 70% because payer portals, faxes and phone trees still produce exceptions. At a nine-provider gastroenterology practice, first-time denials fell from 17% to 9% and each coordinator got about three hours a day back. The case. How we set defaults.

  1. JRW default. JRW, 2026. No public benchmark we trust. The number is a round figure in the range we see in engagements, chosen so the headline errs low. Replace it with your own. Source
  2. 2025 prior authorization physician survey. American Medical Association, 2025. 1,000 practicing physicians from a Medscape panel, 44-question web survey, December 2025, published May 2026: practices complete 40 prior authorizations per physician per week and physicians and staff spend 13 hours a week on them; 40% have staff working exclusively on prior auth; 32% say requests are often or always denied; 95% report care delays. Source
  3. 2024 CAQH Index. CAQH, 2024. Calendar-2023 data from plans and providers: a manual prior authorization takes providers 24 minutes by phone, fax or email and 16 minutes by portal, and costs the provider $12.88 manual, $8.93 partly electronic, $5.38 fully electronic; the electronic path saves 14 minutes per transaction. Source
  4. Share of requests denied or sent back, set below the AMA figure. JRW, anchored on the AMA, 2026. No published rate per request. The AMA's 2025 survey found 32% of physicians say requests are often or always denied, which counts physicians, not requests. We rework a quarter of requests. Replace it with your own. Source
  5. Medical records specialists, median pay. US Bureau of Labor Statistics, Occupational Outlook Handbook, 2025. Median pay $24.59 an hour, $51,140 a year, May 2025. Before benefits and overhead. Source

Also consulted

  1. Medical secretaries and administrative assistants, wages. US Bureau of Labor Statistics, OES 43-6013, 2024. Median hourly wage $21.46 in May 2024, before benefits and overhead. Source
  2. 2024 prior authorization physician survey. American Medical Association, 2024. 1,000 practicing physicians, web survey, December 2024: practices complete 39 prior authorizations per physician per week and physicians and staff spend 13 hours a week on them; 40% have staff working exclusively on prior auth; 31% say requests are often or always denied; 93% report care delays. Source

Where the hours go.

  • Assembling the request

    Pulling the diagnosis, the order, the notes and the payer’s form together from the chart. An agent reads the chart and the payer’s rules and builds the packet the same way every time. How we do it.

  • Submitting and chasing

    Portal, fax, phone or API, then checking back until there is a decision. The agent submits through whatever channel that payer uses, chases on a schedule, and writes the approval number back to the chart.

  • Denials and resubmissions

    In the default, a quarter of requests come back, many for missing evidence. The agent checks the packet against the payer’s requirements before it goes out, so fewer come back.

The prior authorization case: denials nearly halved, three hours a day back per coordinator.

Questions.

Is 40 a week right for my specialty?
It is the AMA’s average across 1,000 physicians, 40% primary care and 60% specialists, prescriptions included. Gastroenterology, oncology, orthopedics and anything with biologics or imaging run higher. A low-intervention primary care practice runs lower. Count a week and put in your own.
Why 16 minutes and not 24?
CAQH measured both: 24 by phone, fax or email, 16 by portal. The default takes the lower one. If most of your payers still want a fax, use 24.
Does this include physician time?
No. The AMA’s 13 hours a week covers physicians and staff together. The model prices staff hours at the medical-records wage. Physician minutes on peer-to-peer reviews are on top. In the AMA’s 2024 survey, 65% of physicians said they do them at least sometimes.
What counts as rework?
A request that is denied and resubmitted, sent back for missing information, or appealed. The AMA’s 2025 survey found 32% of physicians say requests are often or always denied. The default reworks a quarter.

“Copy a link” puts your dials in the address, and we store nothing. A browser agent that supports WebMCP can run this calculator as estimate_prior_authorization_cost. How the calculators work.

Take prior authorizations off your staff’s desk.

Tell us your EHR and your heaviest payers, and we’ll show you which steps an agent can take over. Fixed price per automation. If the first one misses the scope we agreed, you don’t pay.

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Related: Prior authorization statistics · How to cut prior authorization denials · Prior authorization automation · Prior authorization case study