Your medical assistant has a patient waiting.

Your nurse has three messages to return.

Your physician is already running behind.

And somewhere in the middle of all of this, someone is sitting on hold with an insurance company trying to figure out why an MRI still says “pending.”

Welcome to prior authorization.

Prior authorization may be an unavoidable part of healthcare, but much of the work surrounding it is not actually clinical.

So why are medical practices using some of their most valuable clinical employees to manage it?

The Problem Is Bigger Than a Few Forms

According to the American Medical Association's 2025 Prior Authorization Physician Survey, physicians and their staff spend an average of 13 hours every week completing prior authorization work. Physicians also report completing about 40 prior authorizations per physician, per week, and 40% employ staff dedicated exclusively to prior authorization tasks.

That is nearly two full working days every week spent navigating approvals, documentation requirements, payer portals, status checks and follow-ups.

The question is not whether prior authorization creates work.

It clearly does.

The better question is:

Who should actually be doing that work?

Because there is a major difference between the clinical decision behind a prior authorization and the administrative process required to get it approved.

What's Clinical and What's Administrative?

Some parts of prior authorization absolutely belong with clinicians.

Determining whether a patient needs a procedure is clinical.

Choosing the appropriate treatment is clinical.

Providing medical justification is clinical.

Responding to a payer question that requires medical judgment is clinical.

But what about the rest?

Checking whether authorization is required.

Logging into payer portals.

Gathering documentation that already exists in the patient's chart.

Submitting administrative information.

Checking the status of a request.

Following up with an insurance company.

Tracking deadlines.

Documenting approvals and denials.

Escalating the request when clinical input is actually needed.

That is not practicing medicine.

That is managing a workflow.

And workflows can be delegated, standardized and improved.

The administrative burden becomes even clearer when you look at how many systems practices are navigating. A 2026 MGMA poll found that 61% of medical practices had staff accessing seven or more payer portals in a typical week, with 26% using 11 or more.

You Don't Outsource the Medical Decision

This is where some medical practices become uncomfortable with the word outsourcing.

Prior authorization is important. Patient information is sensitive. Mistakes can delay care.

All true.

But outsourcing prior authorization support does not mean outsourcing medical judgment.

You don't outsource the medical decision. You outsource the administrative machinery surrounding it.

A properly structured support team works within the clinic's existing processes and knows exactly when a request requires clinical involvement.

The physician or appropriate clinical team member still provides the medical reasoning.

The administrative team makes sure the request moves.

That team can:

• Verify whether prior authorization is required
• Gather available documentation
• Prepare and submit administrative information
• Monitor pending requests
• Follow up with payers
• Track approvals and denials
• Update the clinic's records
• Escalate cases when clinical input is required

That distinction can completely change how a clinic uses its internal staff.

Your Clinical Team Probably Has Better Things to Do

Medical assistants, nurses and physicians are valuable because of what they know and what they can do for patients.

Yet many practices routinely ask those same employees to spend hours navigating payer websites and chasing administrative requirements.

That creates a hidden cost.

Every hour a medical assistant spends checking insurance portals is an hour that person is not supporting patient flow.

Every administrative task unnecessarily handed to a nurse competes with work that actually requires nursing expertise.

Every routine authorization issue that reaches a physician adds another interruption to an already demanding schedule.

This is not simply a staffing issue.

It is a work allocation issue.

Hiring another clinical employee to absorb administrative work can make an inefficient process even more expensive.

Sometimes the answer is not another medical hire.

Sometimes the answer is simply putting the right work with the right people.

Where Outsourced Prior Authorization Support Fits

For a growing practice, building a dedicated internal prior authorization department may not always make financial or operational sense.

An outsourced administrative team can offer another option.

Instead of asking clinical employees to handle every step, the clinic can establish a dedicated support function responsible for the repetitive portions of the authorization workflow.

The key is structure.

There should be clear procedures for:

Who submits what.

What documentation is required.

How often pending requests are checked.

How approvals and denials are recorded.

When an issue is escalated.

Which situations require clinical review.

When done correctly, an outsourced team does not operate separately from the clinic.

It operates as an extension of it.

And when protected health information is involved, the relationship needs to be structured appropriately. The U.S. Department of Health and Human Services specifically identifies functions such as claims administration, utilization review, billing, benefit management and practice management among activities that can create a business associate relationship under HIPAA.

HHS also explains that the HIPAA Rules generally require covered entities and their business associates to enter into contracts establishing how protected health information will be appropriately safeguarded. You can review HHS's Business Associate Agreement guidance here.

Technology Is Improving Prior Authorization. It Isn't Eliminating It.

Healthcare is moving toward more electronic prior authorization.

The Centers for Medicare & Medicaid Services has already begun implementing changes under its Interoperability and Prior Authorization Final Rule, with certain operational requirements beginning in 2026 and major API requirements for impacted payers taking effect primarily on January 1, 2027.

That is progress.

But better technology does not mean the administrative work disappears.

Someone still needs to make sure the request is complete.

Someone still needs to notice when additional documentation is requested.

Someone still needs to monitor outstanding cases.

Someone still needs to follow up when nothing happens.

And someone still needs to prevent a patient from getting trapped in healthcare's least reassuring sentence:

“We're still waiting on insurance.”

Automation can make a good workflow faster.

It cannot replace ownership of the workflow.

The Better Question for Medical Practices

Instead of asking:

How do we make our clinical staff complete prior authorizations faster?

Try asking:

Which parts of this process actually require clinical expertise?

Keep those with your clinicians.

Then look at everything else.

That is where dedicated administrative support can create real operational leverage.

At Impact BPO, we help medical practices build trained administrative support teams that work as an extension of their operation, handling process-driven back-office work so internal staff can spend less time chasing administrative tasks and more time where they create the most value.

Because your medical assistant was hired to help care for patients.

Not to spend the afternoon refreshing an insurance portal.

Sources & Further Reading

• American Medical Association: 2025 Prior Authorization Physician Survey Findings
• Medical Group Management Association: How Many Payer Portals Is Too Many?
• CMS: Interoperability and Prior Authorization Final Rule
• CMS: Electronic Prior Authorization Overview
• HHS: HIPAA Business Associates Guidance
• HHS: Business Associate Agreement Guidance

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