Prior authorization
Prior authorization staff for medical practices
Prior authorization staff from OffshoreMeds prepare, submit and track prior authorization requests for medical practices, working in your EHR and payer portals with the documentation your providers write. Clinical decisions stay with your US-licensed providers. In the AMA’s 2025 physician survey, physicians reported an average of 40 prior authorizations a week, taking 13 hours of physician and staff time. One flat monthly fee per seat, never a percentage of collections.
Published by OffshoreMeds. Facts last checked October 10, 2026. How we check our numbers.
The work
What the prior authorization team does
- Check whether the patient’s plan requires authorization for the ordered service.
- Gather the notes and orders your providers have already written.
- Submit the request through a payer portal such as Availity, or through the payer’s own process.
- Track pending requests and follow up with the payer until there is a decision.
- Tell your team when a request is approved, denied or needs more information.
The work is done by nurse- and pharmacist-trained people who handle the administrative side of clinical work under your protocols. For drug requests, the decision clocks are on the prior authorization for drugs page.
Scope
Where the clinical line sits
Clinical decisions stay with your US-licensed providers. Our team does not decide medical necessity, choose a treatment or argue clinical questions with a payer’s reviewer. When a payer asks for a peer-to-peer review or a clinical appeal, your provider handles it, with our team preparing the paperwork.
By the numbers
The prior authorization workload in US practices
The 2025 AMA Prior Authorization Physician Survey, published by the AMA in May 2026, asked 1,000 practicing physicians about the work. Physicians reported an average of 40 prior authorizations a week, taking an average of 13 hours of physician and staff time each week. 40% of physicians employ staff who work exclusively on prior authorization.
Revenue impact
How prior authorization connects to billing
A service delivered without a required authorization can be denied. Tracking authorizations before the visit is the front end of the same revenue cycle that the denial management team works at the back end, and accurate codes from the medical coding team keep the claim consistent with what was authorized.
The work involves protected health information daily, so read the HIPAA rules for offshore staff before you start.
Cost
What a prior authorization seat costs
A prior authorization seat costs $1,500 to $2,000 per month. Prices are indicative until your written quote confirms the exact fee. See the offshore medical billing cost comparison for the in-house numbers.
The terms behind each seat
One flat monthly fee per seat, never a percentage of collections. A Business Associate Agreement is signed before anyone touches protected health information. Clinical decisions stay with your US-licensed providers. See all OffshoreMeds services.
Related guides
- Offshore medical billing cost
Seat fee, US in-house cost and percentage-of-collections fees side by side, with the method shown.
- HIPAA compliant offshore medical billing
The Business Associate Agreement, the safeguards, and the payer and state rules that can rule offshore work out.
- Offshore medical coding staff
ICD-10, CPT and HCC coders working in your EHR, audited daily against a published accuracy standard.
- Denial management staff
Appeals, A/R follow-up and root-cause work, measured against published denial-rate benchmarks.
- Insurance eligibility verification staff
Coverage, benefits, authorization and patient-cost checks done before the visit, not after the denial.
- Timely filing limits for medical claims
The federal caps, examples from Cigna, Aetna, Texas Medicaid and Illinois Medicaid, and how to find and track the limit that applies.
- Prior authorization timeframes (CMS rule)
Which payers the CMS rule covers, the 72-hour and 7-day timeframes, what it excludes and the dates that matter.
- Prior authorization for drugs
The Part D and Medicaid clocks that apply to drug requests, the electronic standards and what staff track.
Get Started
Book a free 30-minute call.
Pick a time below. Have these ready: the roles you need, your specialty and your EHR. We’ll come back with a fixed seat quote, candidate profiles to interview and a go-live plan.
Calendar not showing? Open the booking page in a new tab.
Please keep patient information out of the booking notes. A Business Associate Agreement is signed before anyone touches protected health information. See how this site handles your details in the privacy policy.