Solving the Staffing Gap: PA Efficiency in Specialty Practices

Ask a specialty practice administrator what they need and the answer usually comes back fast: more people. The prior authorization volume keeps climbing, the days keep filling, and headcount looks like the only lever left to pull.

This perspective is a reasonable read of the problem. However, it’s only a piece of the puzzle. Before any practice can know whether it needs more staff, it has to know what its current staff are really spending their time on. That question tends to reveal something uncomfortable about prior authorization staff efficiency in specialty practices: A significant share of the workday is going to tasks that don’t require human judgment at all.

What’s called out as a staffing gap is really two problems compounding each other. Understaffing is a genuine capacity problem, and it’s solved by adding people. Misallocation, on the other hand, is an efficiency problem, where trained staff spend hours on clerical retrieval, phone queues, and status checks. The latter isn’t addressed by hiring but by a workflow redesign for specialty PA teams.

This distinction is critical because the solutions aren’t interchangeable. Hiring into a misallocated workflow just buys more capacity for the wrong work. For many specialty practices, fixing misallocation first relieves enough pressure that the hiring question changes shape entirely.

Where Is Prior Authorization Staff Time Actually Going?

Three burdens absorb most of the hours in a manual PA workflow: the fax-and-phone loop, clinical data retrieval, and status monitoring. Viewed as costs, they’re a line item, but when analyzed through a staffing lens, they’re something more useful: recoverable time. We’ll walk through where that time’s going and how to start taking it back.

Each burden shows up as lost time in two ways: how long a task takes to complete, and how many hands each request passes through before it’s resolved. 

Let’s first look at the time it takes to handle tasks. In high-volume specialty settings, manual data digging and payer questionnaires can consume up to 25 minutes of direct staff time per authorization. Multiply that across a specialty caseload and the arithmetic gets serious quickly. A practice processing 40 authorizations a week is spending roughly 16 hours, or two full work days, on clinical data retrieval and form-filling. Very little of that demands clinical or administrative expertise, typically requiring a person to find information that already exists.

The fax-and-phone loop and status monitoring drive the loss the same way: Each one requires a live person, on both ends, to resolve something a system could answer instead. A phone call to check status means someone on your staff is on hold, and someone at the payer is manually looking up the same information a portal could surface instantly. Status monitoring by phone isn’t a task you can batch or delegate to a lower-cost resource — it requires a person with the authority and context to speak to the payer directly. Both phone reliance and constant monitoring dry up staff bandwidth before a file even moves.

A single specialty authorization rarely passes through one set of hands. Roughly 60% of rural practices require at least three employees to manage a single PA request. Each handoff adds context-switching, duplicated review, and the quiet possibility that everyone assumes someone else is following up. Redundancy like this manufactures an artificial sense of understaffing. The practice feels stretched not because there’s too much work for the team, but because three people are doing one person’s job.

The scale of the burden that excessive prior authorization touchpoints and handle time present goes well beyond any single clinic — and the pattern shows up industry-wide, not just in specialty practices. The AMA found that 40% of physicians now employ staff who work exclusively on prior authorization, and hospitals now dedicate an average of 64 administrative and billing staff to these functions, roughly 6.5% of total employment. Entire roles have been created to absorb administrative friction, further exposing the scale of the misallocation problem.

How to Get Real-Time Authorization Status Without Picking Up the Phone

Of all the time sinks, the phone is the most habitual and the most recoverable. It’s also the fastest place to see results, which is why we’re tackling it first — but the same logic (find the manual step, replace it with a system) applies just as well to data retrieval and handoff redundancy, which we’ll return to below.

In a recent MGMA poll, practice leaders named eligibility and prior authorization the single most time-intensive phone task for clinic staff, at 45%. The fix is to move your team onto payer portals as the default and reserve the phone for genuine exceptions — here’s how to make that switch systematically:

Step 1: Inventory which payers offer portal status checks.
Build a simple list of your highest-volume payers and note which ones support online authorization status lookup. Most large commercial plans and Medicare Advantage plans do. This list becomes your default reference, supporting payer portal navigation for prior authorization so staff stop guessing whether a call is required.

Step 2: Confirm every staff member has portal credentials.
Access is the most common silent blocker. If one person owns the login, everyone else defaults to the phone. Ensure each person responsible for tracking authorizations can log in independently.

Step 3: Build a payer navigation playbook.
Portals often bury authorization status under an entirely separate menu from claims or eligibility. Locate the exact path once per payer, take a screenshot of where it’s hidden, and document it in a central playbook. This single reference point eliminates a surprising amount of aimless clicking.

Step 4: Standardize status flags interpretations.
Most portals return a limited set of states: pending, approved, denied, or additional information required. Don’t let staff guess what ambiguous phrasing means. Create an internal standard for action steps: If a portal says “In Review,” does your team check back in 24 hours or 48 hours? Define it explicitly so staff don’t waste time guess-checking.

Step 5: Know when a call is genuinely warranted.
Pick up the phone when the portal status is stale relative to your submission date, when a denial reason is unclear and can’t be resolved in the portal, or when a case is time-sensitive enough that waiting isn’t an option. These are scenarios that justify phone calls.

The goal of adding logic to your team’s authorization-related phone activities isn’t to ban the phone entirely, but rather to make calling a deliberate choice. The desired result is a decision matrix where payer portal navigation becomes the default and the phone becomes the exception. Ultimately, this can help advance administrative efficiency in specialty practices.

The same discipline applies to the other two burdens. Data retrieval stops eating hours once staff have one standing place to pull clinical documentation from, instead of rebuilding it per request. Handoff redundancy stops compounding once one person owns an authorization end-to-end, instead of three people each partially tracking it. Neither requires new headcount — just the same shift already made here: Replace the manual step with a system, and reserve the person for judgment calls only.

What Should Recovered PA Staff Time Be Used For?

Recovering hours only matters if they go somewhere more productive. Prior authorization staff efficiency in specialty practices goes beyond speeding up processes to moving team members toward the work where their judgment influences the outcome.

Three tasks deserve that time first:

Submission quality review

A second set of eyes on documentation completeness before a request goes out catches the errors that otherwise turn into denials — the kind that cost days to unwind. No system can make this call; it takes a trained eye that knows what a payer is actually looking for.

Peer-to-peer coordination

Scheduling and preparing clinicians for peer-to-peer review is high-stakes, deadline-sensitive work — miss the window or send a clinician in unprepared, and a case that should’ve been a straightforward approval turns into a drawn-out appeal. This is judgment work end to end: reading the case, anticipating the payer’s questions, and prepping the clinician to answer them.

Proactive follow-up on high-priority cases

Not every authorization carries the same clinical urgency. Someone should be triaging by priority so the most time-sensitive cases get followed up on first, rather than defaulting to whichever request happened to land first. Deciding what counts as high-priority is itself a judgment call — one a system can’t make on its own.

Recover Capacity Before You Add It

The staffing gap in specialty PA can be significant. But for most practices, the first move should be addressing misallocation of time rather than adding headcount. Doing so will help teams recover the capacity that’s currently being spent on tasks that don’t require a human at all, so that when it comes time to hire more staff, the bedrock for efficiency is already in place.

How do you know you’ve successfully achieved this step? Audit where the hours go, count the touchpoints per authorization, and look honestly at how much time the phone is taking. If the answer is that trained staff are spending their week retrieving data and checking status, then the hiring conversation is premature.

Instead of changing your headcount, you need to change your toolkit.  CareTria Provider Connect directly enables prior authorization staff efficiency in specialty practices. It eliminates the fax-and-phone loop, replaces manual data retrieval with pre-populated documentation, and automates status tracking, recovering exactly the hours this post has been describing.

See how CareTria Provider Connect gives your PA staff their time back.

Frequently Asked Questions About Improving Specialty PA Capacity

How do I know if my practice is understaffed or just inefficient?

Track two things for a couple of weeks: average handle time per authorization, and how many staff members touch a single request. If handle time is dominated by data retrieval and status checks, or if multiple people are working the same file, you likely have a misallocation problem rather than a pure capacity problem.

Will improving efficiency actually eliminate the need to hire?

Not always, but it changes the calculation. Recovering time spent on clerical tasks frees existing staff for higher-value work, which often relieves enough pressure that a new hire isn’t the immediate answer. If the gap persists after the workflow redesign for specialty PA teams, then it’s a genuine capacity issue and hiring is the right response.

Why do payer portals get underused when they’re free?

Usually habit and access. Staff who learned the process on the phone keep calling, and if portal credentials sit with one person, everyone else defaults back. Fixing access and documenting the navigation path for each payer removes most of the friction.

What are the highest-value PA tasks for staff to focus on?

Submission quality review, peer-to-peer coordination, and proactive follow-up on time-sensitive cases. These require judgment, context, and clinical fluency. They’re also the tasks most likely to get skipped when staff are buried in retrieval work.

How many touchpoints should a single authorization require?

Fewer than most practices currently use. Every additional handoff adds context-switching and duplicated review, and it increases the odds that follow-up falls through a gap. Reducing touchpoints per authorization is one of the clearest measures of workflow improvement.