How a Virtual Medical Assistant Handles Prior Authorizations

Prior authorization — the process of getting insurance approval before a service is rendered — is one of the most time-consuming and frustrating administrative burdens in medicine. Physicians spend an average of 16 hours per week on prior auths. A virtual medical assistant can take this completely off your plate.

Why Prior Authorization Is Such a Problem

The AMA's 2023 Prior Authorization Survey found:

• Nearly 40% of physicians have staff who work exclusively on prior auths
• The average practice completes 45 prior auth requests per week
• One in four patients abandons treatment when prior auth is delayed
• 88% of physicians say prior auth negatively affects patient outcomes

What a VMA Does in the Prior Auth Process

1. Identifies which services/medications require prior auth — checking payer-specific requirements in real time
2. Gathers clinical documentation — pulling supporting records from your EHR
3. Submits the request — via payer portal, phone, or fax depending on the insurer
4. Follows up proactively — contacting payers when no response is received within 24–48 hours
5. Handles denials — prepares appeals with supporting clinical evidence
6. Notifies provider and patient — communicates approval/denial and next steps

Turnaround Time Improvements

When a dedicated VMA manages prior auths, typical turnaround drops from 5–7 business days to 2–3 days because follow-up is proactive rather than reactive.

Which EHR Workflows Your VMA Handles

Your VMA works inside your existing EHR to manage the full workflow — whether that's Epic, Athenahealth, eClinicalWorks, or another platform. They follow your protocols and communicate updates directly in the system so nothing falls through the cracks.