Cost of PA

What is prior auth costing you?

A live estimate for payers, MA plans, and risk-bearing providers. Adjust the inputs to match your operation.

Your operation

Volume & mix
%
%
%
Staffing cost
$
$
$
Outcomes & ops
$
bps
$M
%
Estimated annual cost of PA
$9.1M

Across labor, operational drag, and regulatory risk — at your current volume and mix.

Clinical labor
$3.5M
Nurse + MD + non-clinical
Operational drag
$3.4M
Abrasion, appeals, retries
Regulatory risk
$2.2M
Penalties, missed SLAs
With GenHealth: $3.6M
Estimated 60% reduction based on existing customer benchmarks.
Get a custom analysis
labor = (vol × clin/pd/220) × nurse + clin×0.15×md + (vol×(1−clin))/8000 × nc
ops = vol × (abrasion + appealed×85 + urgent×12)
reg = premium × bps + vol × inappropriate × 150
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See your full cost breakdown.

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