Prior Authorization Now Consumes 13 Hours Per Physician Per Week and Virtual Medical Assistants Are the Fix

How Much Time Does Prior Authorization Take From Your Practice Staff?

As of October 2026, the AMA’s Prior Authorization Survey found that physicians and their staff complete an average of 40 prior authorizations per physician per week, consuming approximately 13 hours of staff time. Seventy-four percent of physicians reported that prior authorization denials had increased over the previous five years. For practices struggling to staff these workflows internally, virtual medical assistants trained in prior auth processes offer a faster, lower-cost alternative to hiring full-time administrative employees.

The time cost: Thirteen hours per physician per week means a three-provider practice is losing nearly 40 hours of staff productivity to prior authorization alone, equivalent to one full-time employee doing nothing but chasing approvals.

The denial trend: Prior auth denials are increasing, not decreasing. Seventy-four percent of physicians reported higher denial volumes over the past five years, which means more rework and more staff hours per approval.

The staffing gap: With healthcare administrative roles facing a persistent hiring shortage, practices that cannot fill front-desk and coordinator positions are turning to virtual medical assistants to handle prior auth remotely.

What the AMA Data Confirms

The American Medical Association’s 2025 Prior Authorization Survey, released in 2026, provides the most current snapshot of how prior authorization affects clinical operations. The findings were cited in an October 16, 2026 analysis by HBK CPAs and Advisors examining the broader revenue cycle pressures facing medical groups this year.

The headline numbers are stark. Forty prior authorizations per physician per week is not a clerical inconvenience. It is a structural workload that requires dedicated staff to manage eligibility checks, submit authorization requests, follow up on pending decisions, handle peer-to-peer reviews, and appeal denials. Each step involves phone calls, fax transmissions, portal logins, and documentation gathering that pulls staff away from patient-facing work.

The 13 hours of weekly staff time per physician does not include the clinical time physicians themselves spend on peer-to-peer calls or documentation revisions required by payers. When you add physician time to staff time, the total cost per provider climbs further. MGMA separately reported that 84% of medical groups had higher operating costs in 2026 compared to 2025, and prior authorization labor is one of the largest administrative cost drivers behind that number.

For practices already dealing with staffing shortages, the math is straightforward: you either hire more people to handle a growing prior auth volume, or you find a way to get the same work done with a different staffing model. That is where virtual medical assistants enter the picture.

Why Are Prior Authorization Denials Increasing?

The AMA survey found that 74% of physicians reported increased prior authorization denials over the past five years. Several factors are driving this trend, and each one adds workload to the practices that have to respond.

Payers are applying more granular clinical criteria to authorization decisions. Services that were previously approved with a standard request now require additional documentation, clinical notes, or peer-to-peer physician reviews before approval. The criteria change frequently, and keeping up with payer-specific requirements across multiple insurance carriers is a full-time job in itself.

At the same time, CMS finalized new prior authorization requirements in 2026 that apply to Medicare Advantage plans, Medicaid managed care plans, and qualified health plans on the federal exchanges. These rules require impacted payers to provide a specific reason when denying a prior authorization request, which is a step forward for transparency but also means practices need staff who can interpret the denial reason and respond with the right documentation.

We see this play out across the practices we work with. A denial that previously took one phone call to resolve now requires a formal appeal with supporting clinical documentation. A single complex denial can consume two to three hours of staff time between pulling records, drafting the appeal letter, and following up with the payer. Multiply that across a panel of patients and the hours add up fast.

The Real Cost of Staffing Prior Auth In-House

To understand why virtual medical assistants are gaining traction for prior authorization, you need to see what it actually costs to handle this workflow with in-house staff.

Cost Factor	In-House Staff	Virtual Medical Assistant
Hourly labor cost	$18 to $25/hour plus benefits	$8 to $15/hour, no benefits overhead
Weekly cost per physician (13 hrs)	$234 to $325+ per physician	$104 to $195 per physician
Hiring timeline	4 to 8 weeks to hire and train	Placed and working within days
Turnover risk	High turnover in admin roles; restart hiring cycle	Replacement handled by VA provider
Scalability	Requires new hire for each added provider	Add hours or a second VA as volume grows

For a detailed breakdown of what virtual medical assistants cost across different service models, see our medical virtual assistant cost guide.

Can a Virtual Medical Assistant Handle Prior Authorization?

Yes. A trained virtual medical assistant can manage the full prior authorization workflow remotely, including eligibility verification, authorization submission through payer portals, status tracking, peer-to-peer scheduling, denial documentation, and appeal submission. The work is system-based and phone-based, which means it does not require physical presence in the office.

The key is training and payer knowledge. A virtual medical assistant who understands the prior auth requirements for major payers like UnitedHealthcare, Aetna, Cigna, Blue Cross Blue Shield, and Medicare Advantage plans can process requests faster than a generalist front-desk employee who handles prior auth as one of many responsibilities. Specialization drives efficiency, and efficiency is what reduces the 13-hour-per-physician weekly burden.

In our experience placing virtual medical assistants with healthcare practices, the prior authorization workflow is one of the highest-value use cases. Practices that move this function to a dedicated VA typically see faster turnaround on approvals, fewer missed deadlines, and less clinical staff pulled away from patient care. The VA works inside the practice’s EHR and payer portals, follows the same documentation standards, and communicates with the clinical team through secure messaging.

Virtual nurses trained in clinical documentation can also support the peer-to-peer review process, which is one of the most time-consuming steps in a prior auth denial. Learn more about how virtual nurses support healthcare practices on our services page.

How to Shift Prior Auth to a Virtual MA

If your practice is ready to move prior authorization off your in-house staff, here is how to set up the transition with a virtual medical assistant.

1. Audit your current prior auth volume. Count the number of prior authorizations your practice submits per week and the average time each one takes. This gives you the baseline for how many VA hours you need.

2. Identify your top payers by auth volume. Most practices see 60 to 80% of their prior auth volume concentrated in three to five payers. Your VA needs to know those payers’ portals, requirements, and escalation processes first.

3. Map the workflow from request to resolution. Document each step: who initiates the request, where the clinical documentation lives, how the request is submitted, who follows up, and how approvals and denials are communicated back to the clinical team.

4. Set up secure system access. Your VA needs HIPAA-compliant access to your EHR, payer portals, and fax system. Work with your IT team or EHR vendor to create a user account with appropriate permissions.

5. Establish communication protocols. Define how the VA will communicate with your clinical staff about urgent authorizations, peer-to-peer requests, and denials that require physician input. Secure messaging platforms work best for real-time coordination.

6. Start with a defined scope. Begin by assigning your highest-volume payer’s prior authorizations to the VA. Once the workflow is running smoothly, expand to additional payers and add denial management and appeals.

Common Mistakes When Delegating Prior Auth

Shifting prior authorization to a virtual medical assistant works when the transition is structured. Here are the mistakes that slow it down or create problems.

Assigning prior auth without documenting the workflow first. If your current process lives in the heads of two or three staff members, a VA cannot replicate it. Write down every step, every portal login, every payer-specific requirement before onboarding. The documentation itself often reveals inefficiencies you can fix at the same time.

Expecting a generalist VA to handle clinical prior auth without training. Prior authorization requires specific knowledge of CPT codes, ICD-10 codes, payer medical necessity criteria, and appeal procedures. A virtual assistant trained in healthcare administrative workflows will outperform a general administrative VA from day one. This is why we vet and train our VAs specifically for healthcare before placing them with a practice.

Overlooking the patient care coordination side. Prior auth delays affect patients directly: delayed procedures, rescheduled appointments, and gaps in medication coverage. A virtual patient care coordinator can bridge the communication gap between the authorization process and the patient, keeping them informed and reducing no-shows caused by auth delays.

Failing to track metrics after the transition. Measure authorization turnaround time, denial rate, appeal success rate, and staff hours saved. These numbers tell you whether the VA is performing and give you the data to justify expanding the model to other administrative functions.

Frequently Asked Questions

Next Steps

The AMA data confirms what your front desk already knows: prior authorization is consuming hours that your staff does not have. The practices that are solving this are not hiring more in-house employees. They are placing trained virtual medical assistants who specialize in this exact workflow.

Start by counting your weekly prior auth volume and the hours your team spends on it. If the number matches the AMA average, a virtual MA can cut that time significantly at a lower cost than adding headcount.

DoctorsVA places HIPAA-trained virtual medical assistants who specialize in healthcare administrative workflows, including prior authorization, patient coordination, and clinical documentation support.