Prior authorization

What prior auth costs you, and how to cut it

Three costs, and what changes when the routine part is done for you.

Why it grows with every surgeon you add. Practices complete about 39 prior auths per physician per week, and physicians and staff spend about 13 hours per physician per week on them (AMA, 2024). Add a surgeon, and the auth work comes with them.

The work below is done by an AI we built. It signs into the same payer and UM portals your team uses, like a new employee would, and does this work itself. No integration project, no API build.

Cost 1

The staff time

About 39 prior auths per physician per week (AMA, 2024).
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Each one done by hand costs about $12.88 (CAQH, 2024).
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Then someone chases the status, because payers do not call you.
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Headcount that grows with volume40% of practices have staff who do nothing but auths.
How we solve itThe AI does the routine part: checks whether an auth is required, gathers the documentation from the chart, submits it in the right portal, checks status every day and saves the answer with the case. Your people keep the exceptions.
The return
50,000 auths a year, manual at $12.88$644K
The same auths, electronic at $5.38$269K
Saving you $375K a year
on handling alone. The calculator below runs your volume.
Cost 2

The write-offs

About 85% of payers allow no retro authorization.
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A case done without a valid auth denies, and cannot be billed to the patient.
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It is written off, not delayed.
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Revenue gonefor a service you already delivered.
How we solve itBefore every case the AI confirms the auth is required, files it with the company that actually reviews it, and checks the approval against the codes, dates and units that will be billed. Denials get prevented, not appealed.
The return
Minutes, not weeks
problems fixed before the case, not fought after a denial.
Cost 3

The surgeons' time

A documentation gap turns into a pend.
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The pend turns into a peer-to-peer call.
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A surgeon spends clinic time defending an MRI.
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Clinic time lostand the scan or surgery slips while it is argued.
How we solve itThe AI submits against the plan's own criteria with the conservative-care notes attached, files with the right review company, and works pends every day. Surgeons get pulled in only on genuine medical-necessity calls.
The return
3x the working hours
the queue is worked 24 hours a day instead of one shift.
39
prior auths per physician per week, the AMA's 2024 average across specialties
13 hours
of physician and staff time per physician per week on auths (AMA, 2024)
58% cheaper
per auth, moving from manual to electronic handling: $12.88 down to $5.38 on CAQH's own numbers, $7.50 back on every auth

What this looks like in practice

$1.4M

One Florida cardiology service line was writing off $1.4 million a year to prior auth, across just three payers and one physician. That is where we started with them: our AI running auth for those three payers, extending into eligibility and denials next.

What it is worth to you

Three numbers of yours. The AMA average is filled in; replace it with your own count if you have it.

Surgeons and non-operative providers
AMA 2024 average is 39
CAQH 2024 puts it at $12.88
Prior auths a yearphysicians, times auths a week, times 52
81,120
Handling cost todayat your manual rate
$1M
Handling cost electronicat CAQH's $5.38
$436K
Back on your books, every year
$608K
A+ from KLAS, June 2026Becker's 2026 Top RCM CompaniesHeadspace · SonderMind · Ideal Eye SurgeryRothman Orthopaedic Institute · Columbia Orthopaedic GroupNo code list. No payer network to join.

Worth twenty minutes?

Tell us your physician count and your top three payers and we will show what the routine part of auth looks like done for you, and what stays with your team. If your workflow is already tight, we will say so.

Reply with a day that works and we will set it up.

Auths per physician per week, hours per physician per week, and the share of practices with dedicated authorization staff are the American Medical Association's 2024 Prior Authorization Physician Survey (1,000 physicians, all specialties). Manual and electronic per-auth costs are the 2024 CAQH Index; the 58% reduction and the $644K, $269K, $7.50 and $375K figures all derive from those two published costs, with dollar totals at an assumed 50,000 auths a year; they are an industry benchmark rather than a Magical price. Retro authorization availability, UM vendor routing, the approval-does-not-guarantee-payment rule and round-the-clock operation are from Magical's RCM workflow reference. The cardiology figure is the write-off exposure at a current Magical engagement, unnamed at the customer's discretion; it is the size of the problem we were brought in on, not a result to date. KLAS A+ likelihood to recommend, June 2026. Headspace, SonderMind and Ideal Eye Surgery are published case studies; Rothman Orthopaedic Institute and Columbia Orthopaedic Group are current Magical customers. The calculator uses only the numbers you enter.