If you run a medical practice in the U.S., you probably already know how prior authorization eats away at time. A physician sees the patient, documents the need, and recommends a course of treatment—then everything grinds to a halt. Staff fax forms, upload PDFs to payer portals, or sit on hold with insurance companies just to prove what's already obvious: the patient needs care. 

This waiting game frustrates everyone. Patients wonder why their therapy or scan hasn't been scheduled. Nurses and medical assistants get buried in paperwork instead of supporting clinical tasks. And healthcare providers lose hours every week chasing signatures and approvals instead of seeing more patients.  

For many practices, a prior authorization company has become the fix. These offshore firms take over the paperwork. Moreover, they keep up with shifting payer rules and push approvals through faster than an in-house team.  

Why Prior Authorization Takes So Long 

Insurers and regulatory authorities didn't design prior authorization (PA) to be easy. In theory, it helps payers control costs and prevent unnecessary procedures. In reality, it often slows care and clogs revenue cycles. Here's why:  

  • Every payer has its own rules, and providers must apply for PA based on their particular requirements. What Aetna wants isn't what UnitedHealthcare requires. Even within the same carrier, policies differ by plan. 
  • The criteria for securing PA keep changing. Just when your team learns the process for a particular medication, the insurer usually updates the checklist. Hence, prior authorization specialists must keep them up-to-date. 
  • Many insurers still ask to communicate via phone calls and faxes. The manual process usually extends to a five-minute request that engages staff for the whole day. Specialists can communicate with them in their preferred way, and that will significantly reduce the time for securing PA. 
  • Tiny billing mistakes by exhausted internal staff usually create denials. A wrong diagnosis code or a missing clinical note sends the request back to square one.  

Put all that together, and it's no wonder prior authorization eats up dozens of hours per provider each week. Here, outsourced PA experts come into action and streamline the process.   

What a Prior Authorization Company Does 

So, now the obvious question comes to our mind: how does outsourcing help? A prior authorization company focuses on this one piece of the revenue cycle. Their teams know payer requirements inside and out, and they use that expertise to move requests through more quickly. Typical services include:  

  • Eligibility checks before the visit so providers know what's covered. 
  • Submitting complete requests with the right CPT and ICD-10 codes attached. 
  • Following up daily with payers to prevent requests from sitting idle. 
  • Appealing denials when insurers push back without valid reasons.  

Because securing prior authorization is their specialty, the third-party experts keep up with policy updates. Moreover, they know exactly what documentation each insurer expects. Hence, they can ensure optimum precision in not only securing PA but also performing end-to-end RCM accurately.   

How Outsourcing Speeds Up Approvals 

Let's explore why these third-party prior authorization companies tend to get better results than in-house staff juggling multiple roles. 

1. Deep payer knowledge 

Authorization specialists track payer policies full-time. They know which drug needs a step-therapy note, which imaging study requires a peer-to-peer call, and which codes trigger automatic denials. That knowledge saves days of trial and error. 

2. Better use of technology 

Many prior authorization companies use proprietary software that tracks cases in real time. Instead of sticky notes or spreadsheets, practices see dashboards showing where every request stands. That visibility alone prevents delays. 

3. Faster follow-ups 

Insurers are more likely to respond when a request is consistently nudged. A dedicated prior authorization team makes those calls and portal checks daily. In-house staff rarely have the bandwidth. Hence, employing third-party specialists streamlines follow-ups and reimbursement as well. 

4. Cleaner submissions = fewer denials 

The fastest way to pre-approval is accuracy on the first try. Outsourced prior-authorization specialists package requests with exactly what the payer wants. This optimum precision results in fewer returns for “missing information.”  

The Bigger Benefits of Outsourcing Prior Authorization for Practices 

The speed boost is obvious, but outsourcing prior authorization also improves the overall health of the practice. These third-party experts enable providers to offer top-notch patient care. With their assistance, patients don't need to wait weeks to start treatment. That improves overall satisfaction and outcomes.  

Outsourcing also ensures less staff burnout. Medical assistants and front desk staff stop spending entire afternoons on hold with payers when a third-party expert takes care of administrative responsibilities. Moreover, outsourced experts ensure a steadier revenue cycle. When approvals come faster, claims drop sooner, and reimbursement arrives without as many delays.  

PA specialists reduce the overall turnover time. Staff who feel supported are less likely to leave over administrative overload. In addition to that, patients enjoy smoother scheduling and fewer insurance headaches. Above all, smooth PA offers the confidence that patient care won't stall because of red tape.