Top 5 Myths About Medical Prior Authorization Services

In healthcare, few processes generate as much frustration as prior authorization (PA). According to the AMA, physicians and staff spend an average of 14 hours per week on prior authorization tasks, costing practices both money and productivity. Yet, misconceptions about Medical Prior Authorization Services prevent many organizations from improving this process.

At Finnastra, we’ve seen first-hand how these myths harm practices—leading to delays, denials, and lost revenue. Let’s debunk the top five myths holding providers back, and show how the right Healthcare Prior Authorization Services partner can turn PA into a streamlined, revenue-protecting process.

Myth #1: “Prior Authorization Is Just Paperwork.”

Reality: Prior authorization is not just about filling forms—it’s a highly regulated compliance process that requires payer-specific documentation, coding accuracy, and detailed clinical justification.

• Data Point: A 2023 CAQH study found that 12% of all claim denials stem from prior authorization errors.
• Example: A cardiology practice delayed a catheterization procedure because the request was missing a single documentation element. The result? A denial, resubmission, and three weeks of revenue delay.

Our Prior Authorization Services are designed to simplify complex payer rules, ensuring documentation is correct the first time and preventing costly resubmissions.

Myth #2: “Eligibility and Insurance Verification Aren’t Part of Prior Authorization.”

Reality: Many denials occur because providers initiate PA without first confirming insurance verification services and eligibility verification services.

• Benchmark: The MGMA reports that eligibility issues cause 20–25% of all denied authorizations.
• Example: A surgery center submitted multiple orthopedic requests without eligibility verification. The insurer later determined the patient’s coverage had lapsed, resulting in $15,000 of uncompensated care.

As a leading Prior Authorization Services Company, Finnastra ensures every PA begins with accurate insurance and eligibility verification—eliminating the #1 source of avoidable denials.

Myth #3: “Prior Authorization Only Affects Scheduling, Not Revenue.”

Reality: Delays in prior authorization directly affect cash flow. Services cannot be billed until approval is secured, creating bottlenecks that push reimbursement weeks downstream.

• Data Point: The AMA reports that 64% of providers wait at least two business days for approvals, with 30% waiting seven days or more.
• Financial Impact: If a procedure worth $4,000 is delayed by even three days, practices lose both time and opportunity cost. Multiply that across 50+ requests per month, and the revenue freeze is staggering.

When you work with a dedicated Prior Authorization Services Company like Finnastra, your practice experiences faster turnaround, cleaner submissions, and faster cash flow.

Myth #4: “Technology Alone Can Solve Prior Authorization.”

Reality: While automation tools help, technology alone cannot resolve payer-specific nuances. Insurers often require manual documentation review, phone calls, and clinical validation.

• Case Study: A multi-specialty clinic adopted automated PA software but still faced a 28% denial rate due to incomplete clinical data uploads.
• Lesson: Human expertise, paired with technology, is essential for successful outcomes.

At Finnastra, we blend technology-enabled workflows with expert PA specialists who track, escalate, and resolve every request until approval is secured.

Myth #5: “In-House Staff Can Handle It Just as Well.”

Reality: While some practices try to manage PA in-house, the workload often overwhelms staff. Burnout rises, errors multiply, and patient care suffers.

• Benchmark: According to the AMA, 88% of providers describe prior auth-related administrative burden as “high” or “extremely high.”
• Example: A clinic with three front-office staff found that 40% of their time was consumed by chasing PAs. Outsourcing reduced that burden by 75%, freeing staff for patient-facing work.

Finnastra scales with your practice. Our Medical Prior Authorization Services provide dedicated support, ensuring approvals happen quickly without exhausting your internal team.

The Finnastra Advantage: Busting Myths, Delivering Results

When you partner with Finnastra, you don’t just get prior authorization processing—you get a strategic solution that eliminates myths and delivers measurable results:

• Faster Approvals: 40–60% quicker turnaround vs. industry averages.
• Higher Accuracy: 90%+ first-pass success rates.
• Revenue Protection: Prevent denials before they happen.
• Scalable Support: From 50 to 500+ requests per month, we handle it.

Executive Question:

If your practice loses even 10% of monthly revenue to PA-related delays and denials, what is that costing you annually? And how much more could you earn with approvals streamlined and denials minimized?

Conclusion

Misconceptions about Healthcare Prior Authorization Services cost providers time, revenue, and patient trust. By understanding the truth behind these myths—and working with experts—your practice can turn prior authorization from a burden into a competitive advantage.

Our Prior Authorization Services are designed to simplify workflows, accelerate approvals, and ensure compliance across every payer.

Don’t let myths stall your practice’s growth. Partner with Finnastra—the Prior Authorization Services Company that transforms complexity into clarity.

Contact Us Today to streamline your approvals and protect your revenue.