The Cost of Prior Authorization for Your Resources


An article in Medical Economics entitled: “Electronic prior authorization: The solution to physicians’ headaches,” outlined the benefits of electronic prior authorization (ePA). Electronic prior authorization not only reduces the work and cost involved in prior authorizations, but also makes patients happier. Instead of being forced to wait a day or two for a pre-authorization to arrive, usually after an unsuccessful trip to the pharmacy. With ePA patients are able to get a prescription approved before leaving the physician’s office.

Going to the pharmacy and discovering that a medication needs pre-approval is a huge patient dis-satisfier. So from the patient’s point of view, ePA is much better.

Currently, practices spend a lot of time and money on prior authorization of all kinds, including the pre-approval of prescriptions.

According to a recent study, prior authorization takes up an average of 1.1 hours per week for primary care physicians, 0.8 hours per week for medical specialists, and 0.7 hours per week for surgeons. And that does not include the amount of time they devote to formularies, which are intertwined with prior authorizations.

Primary care nurses spend an average of 13.1 hours per physician per week on prior authorizations and 3.8 hours per week on formularies, the study also found. Electronic prior authorizations allow these clinicians to convert most of that time to patient care duties.

Noting that 90 percent of prior authorizations requests require a phone call or a fax, Surescripts estimates the cost of completing these requests at between $2,000 and $14,000 per physician per year. Prior authorizations are required for 2 percent to 4 percent of prescriptions. Considering that billions of prescriptions are ordered every year, that adds up to a great deal of extra work and money.

In most cases, when an urgent request is filed, it could take 24 hours for a decision. And, generally, when a standard request is filed, it could take 15 days for a decision.

What kinds of drugs need prior authorization?

  • Drugs that have dangerous side effects
  • Drugs that are harmful when combined with other drugs
  • Drugs that you should use only for certain health conditions
  • Drugs that are often misused or abused
  • Drugs that a doctor prescribes when less expensive drugs might work better

When providers use Electronic Prior Authorization (e-PA) from eazyScripts, there is no long waiting period for insurance authorization. EazyScripts e-PA offers an intuitive electronic prior authorization tool so healthcare providers can quickly and seamlessly treat their patients. The entire e-PA process can take from two-to five minutes for approval. By streamlining the entire Prior Authorization process with patient insurance companies, eazyScripts saves invaluable time.

And, when you combine e-PA with eazyScripts’ e-prescribing, providers save even more time. Our e-prescribing software allows physicians to submit electronic prescriptions, at pharmacies convenient for their patients, right from their mobile devices. With SureScripts Certification connecting physicians to 90% of pharmacies in the United States, eazyScripts offers the most robust one-touch e-prescribing software available in the healthcare industry.

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