Prior authorization delays, in 3 steps
Count the hours your team spends, send patients insured through work to their benefits office, and ask who reviewed each denial.
Co-founder, JotPsych
Your patient's plan wants a prior authorization before the next refill or the next round of visits. Your staff make the calls. Your patient waits.
American Medical Association, “AI in health insurance claims, why prior authorization is so difficult and how AMA fights to fix it,” April 4, 2025, 12 minutes. https://www.youtube.com/watch?v=cBaOimbtKdg
Dr. Bruce Scott was AMA president in April 2025. Scott covers what prior authorization costs patients and physicians, how employers can influence their health plans, and who reviews denials.
Dr. Bruce Scott, then president of the American Medical Association (AMA), covers the wait your patients face in a 12-minute AMA video. Some patients leave the pharmacy without their medication, Scott says at 2:17.
- Count the hours your team spends on prior authorizations. Log each request for one week: the plan, the drug or service, the date, and the minutes your staff spend on calls and forms. You'll see which plans cost you the most time. Scott gives the AMA's weekly count of prior authorization hours at 3:37.
- Send patients insured through work to their benefits office. Employers pay most of the premiums, Scott says at 5:59, and the benefits office can press the plan for an employee. The office also chooses next year's plan. The hassles your patients report can change that choice, Scott says at 6:58.
- Ask who reviewed each denial. Ask the plan for the reviewer's name and training, and ask for a psychiatrist on any peer-to-peer call. At 4:45, Scott tells of a scan denied by a reviewer who wasn't a physician. Expect a reviewer without your training.
In the AMA's survey of 1,000 physicians in December 2025, prior authorizations took 13 hours a week per physician, staff time included. Compare your own count. Only 16% of physicians in peer-to-peer calls said the plan's reviewer was often or always qualified.
The AMA's 2025 survey counted 13 hours of physician and staff time per physician each week. Count your own hours for one week to see what prior authorization costs your practice.
Our view
We agree with Scott at 9:47: plans should use AI to approve care, not to deny it faster. Your best answer to any reviewer is the record.
When a reviewer asks why your patient needs the care, your note should already give the reason, in words a stranger can follow. Keep each authorization's number, authorized visits, and end date in your patient's chart, and count the visits used, so no visit runs past an authorization. Renew before the end date.
JotPsych records each prior authorization's dates and authorized visits, then counts the visits documented and billed against the authorization.
Book 15 minutes- American Medical Association, "AI in health insurance claims, why prior authorization is so difficult and how AMA fights to fix it," AMA Update, YouTube, April 4, 2025, 12 minutes. Dr. Bruce Scott, AMA president, with Todd Unger, AMA chief experience officer.
- American Medical Association, "2025 AMA prior authorization physician survey": a 44-question web survey of 1,000 practicing physicians drawn from the Medscape panel, December 2025.