Prior Authorization Cost Calculator
Move the sliders below with your practice’s own numbers and watch your real cost update instantly. No email required to see the result.
Tell us about your practice
How this is calculated: weekly hours equal total prior authorizations (providers times authorizations per provider) multiplied by minutes each one takes, divided by 60. Weekly cost is those hours multiplied by your hourly staff cost. This reflects the numbers you enter, not a published industry average, since volume and staffing vary widely by practice.
Prior authorization ties up staff time that could go toward patient care, and the cost adds up fast once you count minutes, wages, and follow-up calls. For a broader look at what to check before submitting a request, see our Prior Authorization Readiness Checklist.
Why it matters
Why Prior Authorization Costs Keep Climbing
Payer rules change often, and each new requirement adds a step before a claim can even be submitted. Practices that do not verify eligibility and authorization requirements ahead of the visit often end up reworking the same request more than once, a pattern covered in Why Real-Time Eligibility Verification Is No Longer Optional. A missed or incorrectly filed prior authorization is also one of the more common causes of claim denials, which we break down in Denial Root Cause Analysis: The 5 Categories to Track.
What actually helps
How Practices Reduce This Cost
The practices that bring this number down tend to do the same few things: checking payer rules and eligibility before the visit, standardizing documentation so staff are not rebuilding each request from scratch, and tracking which payers or procedures cause the most delays. Prior authorization is also rarely the only place revenue slips through, alongside issues like the ones covered in Charge Capture: Top 10 Leakage Points in Ambulatory Practice.
Common questions
Frequently Asked Questions
What counts as a prior authorization here?
Any request sent to a payer for pre-approval before a procedure, medication, or service. That includes filling out forms, calling payers, sending faxes, and appealing denied or pended requests.
Is this number exact for my practice?
It is a plain estimate built from the volume, time, and labor cost you enter above, not a guarantee. It does not account for delayed care or staff burnout, so your actual cost is often higher than what is shown.
How can this cost actually be reduced?
Common approaches include checking payer rules and eligibility before submission, using templated documentation tied to your EHR, and tracking denial patterns by payer so recurring issues get fixed at the source.
Do you store the numbers I enter?
No. The calculation runs entirely in your browser. Nothing you enter into the sliders is sent anywhere unless you choose to request a consultation below.
If you want to see this cost alongside your practice’s full financial picture, Your Billing Reports Look Fine. Here is Why You are Still Losing Money covers the other numbers worth tracking.
Want a plan to bring this number down?
Get a free consultation on reducing prior authorization time in your practice, or see the platform in a live demo. No obligation either way.
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