What it costs
What it costs to outsource prior authorization
Vendors price prior authorization per request (Staffingly prints from $4 to $8 per authorization; Practolytics, $15 to $35 per case), per specialist per week or month, or inside a percentage-of-collections billing contract. A Soft Home Global prior authorization seat is a flat $1,900 a month for one full-time person working your requests in your own systems, one month minimum.
The ways this work is priced
The same work is sold in three units. Compare them only after multiplying each one by your own monthly volume of requests.
| Pricing model | What vendors publish | Suits | Watch for |
|---|---|---|---|
| Per authorization or per case | Low or uneven volume, or a practice testing a vendor on a few cases first. | What counts as one request (a case, a code, a renewal) and whether peer-to-peer scheduling, retro requests and appeals cost extra. | |
| A dedicated specialist, by the week |
| Steady volume where you want a short commitment. | A month is about 4.3 weeks, so multiply before comparing with a monthly price. |
| A dedicated specialist, by the month |
| Volume that fills a working week, every week. | Minimum headcounts, and whether the person works only on your requests. |
| Inside a percentage-of-collections contract |
| A practice handing over its whole revenue cycle. | The fee follows collections, not authorization volume, so it is hard to see what this one job costs. |
Each figure is quoted from the vendor’s own page and dated by what that page says. We do not rate other vendors’ work; a price here is what they publish, nothing more.
Per request or a seat: the break-even with your own numbers
Divide the seat’s monthly price by the per-request price you have been quoted. The answer is the number of requests a month at which the two cost the same.
At $1,900 a month, a seat costs the same as 55 requests a month at the top of Practolytics’ published range, or 127 at its bottom. Below that volume, paying per request is cheaper and we would say so. Above it, a seat is, and it also does the work per-request pricing tends to leave with your front desk.
Count more than submissions. Gathering the clinical notes before a request goes in, chasing a pending status, booking a peer-to-peer and catching an authorization before it expires are all part of the job. Ask any per-request vendor which of those its price includes.
What drives the price
- Payer mix: Medicare Advantage, Medicaid managed care and commercial plans each run their own forms, portals and benefit managers
- Service mix: imaging, injections, infusions and surgery carry different documentation
- How requests go in: portal, fax or phone, and how many portals
- Whether the chart is ready when the request is due, or has to be chased first
- How often peer-to-peer reviews and retro requests come up
- The hours you need covered, which for this work means US business hours
What our seat includes, and what it does not
One full-time person, $1,900 a month, working your requests in your own practice management system and payer portals through logins you issue. A Business Associate Agreement is signed first.
- Requests submitted ahead of scheduling, not after
- Status chased rather than waited on
- Peer-to-peer reviews scheduled when a payer asks for one
- Clinical documentation gathered before submission
- Expiring authorizations flagged before they lapse
- Clinical judgement: your provider argues medical necessity, including on a peer-to-peer
- A promised approval rate: the payer decides, and no vendor controls that
- Portal or software fees you already pay
When outsourcing prior authorization is the wrong call
- Your monthly volume sits under the break-even above: pay per request instead
- Your payer or Medicaid contract restricts offshore access to patient data: our seats work from Rawalpindi, Pakistan, and we will check this with you on the first call
- The real delay is notes only your providers can write: no outside team fixes that
The decision clock behind the work
From 1 January 2026, CMS-0057-F sets decision timeframes for the payers it covers. Which payers those are, and which they are not, matters before you count on a date. Our free prior authorization deadline calculator quotes the rule and says where it stops.
Questions
How much does prior authorization outsourcing cost per request?
The published per-request prices we found run from Staffingly’s from $4 to $8 per authorization (a starting price) to Practolytics’ $15 to $35 per case, each read on the vendor’s own page on 9 October 2026. Ask what counts as one request before comparing.
Is a dedicated prior authorization specialist cheaper than paying per request?
Only above a certain volume. Divide the monthly price of a dedicated person ($1,900 for our seat) by the per-request price you were quoted: above that many requests a month, the dedicated person costs less.
Does an outsourced team handle peer-to-peer reviews?
It can schedule them, prepare the documentation and make sure nothing lapses. The conversation itself is your provider’s, because it is a clinical argument.
Can offshore staff work prior authorizations?
Yes, under a Business Associate Agreement, working inside the practice’s own systems, where the practice’s contracts allow it. Some payer and Medicaid contracts restrict offshore access to patient data; check yours first, and we will ask on the first call.
Sources
- Staffingly — Staffingly prints a starting price per prior authorization (a floor; the page does not define one authorization).
- Practolytics — Practolytics’ page states what outsourcing authorization runs per case, falling with volume.
- Staffingly — Staffingly prints a weekly starting price for a dedicated prior authorization specialist.
- Verimedix, 2 August 2026 — Verimedix prints a starting monthly price for a dedicated white-label prior authorization specialist, with a two-resource minimum stated on the same page.
- Neolytix, 27 July 2026 — The benchmark percentage-of-collections range for outsourced medical billing.
Sources checked 9 October 2026.
Three ways to check us before you commit to anything.
Next step
One prior authorization seat, $1,900 a month
Twenty minutes is enough to tell whether a seat fits your volume. If a per-request vendor would cost you less, we will say so.
Or write to ops@softhomeglobal.com