TheraIntel Prior Authorization Burden Calculator · Generated

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What Is Prior Authorization Actually Costing Your Pharmacy?

Prior authorization is the number one daily frustration for pharmacists, and most of that cost is invisible. Enter your numbers below to see the labor hours, dollars, and FTE-equivalent it consumes, then how much telepharmacy and automation could reclaim.

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Your Inputs

Editable

Prior authorizations handled per month

The one number you already know. Count every PA your team initiates or works.

Average minutes per PA 20 min

Industry work-time estimate is ~20 min for a manual PA.

Pharmacist hourly wage $66

BLS national mean is ~$66/hr. Hospital and clinical staff often run $75 to $85.

Share of PAs done by a pharmacist 60%

The rest is assumed handled by a technician.

Cost basis

Fully loaded adds employer benefits to wages, the realistic CFO-facing number. Wage-only shows base salary cost. Set the load under Advanced.

Technician hourly wage $21

BLS pharmacy technician mean is ~$21/hr.

Benefits load on wages 30%

Applied only on the fully-loaded basis. BLS ECEC puts benefits near 30% of total compensation.

Share submitted electronically (ePA) 30%

ePA averages ~4 min, lowering your effective time per PA.

PA denial rate 7.7%

2024 industry denial rate.

Rework minutes per denial 15 min

Productive hours per FTE / year 2,080

Your PA Burden

Blended rate $62.40/hr

Total annual PA labor burden

$81,644

base processing plus denial rework, fully loaded

Base PA processing

$75,878

1,216 hrs / yr · ~15.2 min/PA

Denial rework

$5,766

92 hrs / yr

1,308total staff hours / year

0.63FTE-equivalent consumed

$17.01labor cost per PA

What Delegation, Automation, or Remote Support Could Reclaim

PER YEAR

Conservative · 50%

$40,822

654 hrs · 0.31 FTE freed

Likely · 70%

$57,151

916 hrs · 0.44 FTE freed

Aggressive · 85%

$69,398

1,112 hrs · 0.53 FTE freed

Reclaim applies to total burden (processing plus rework). Not all PA work moves through one operating model, so these are reduction scenarios, not a single guaranteed number.

~370 PAs a year are denied, costing ~281 hours of rework, included in the total above. 82% of denials are overturned on appeal, yet fewer than 11% are ever appealed, which is access and revenue left on the table, separate from this labor cost. Denial rate and appeal data: industry figures, 2024.

#1Prior authorization is the top daily frustration for pharmacists.

~20 minAverage work time to complete a single manual PA.

7.25 / 10Average pharmacist burnout score, with PA a leading driver.

How we calculated this ▾

Coefficient	Default	Source	Type
Minutes per manual PA	20	Surescripts work-time estimate (2024)	Vendor
Minutes per ePA	~4	ePA average response ~3 min 54 sec (Surescripts, 2024)	Vendor
Pharmacist wage	$66.10/hr	BLS OEWS, May 2024 ($137,480/yr mean)	National
Technician wage	$20.90/hr	BLS OEWS, May 2024 ($43,460/yr mean)	National
Benefits load	+30%	BLS ECEC, benefits ~30% of total compensation	National
PA denial rate	7.7%	2024 commercial-claims denial rate	Industry
Appeal overturn / appeal rate	82% / <11%	Denials overturned vs. ever appealed	Industry
Productive hours per FTE	2,080	Conservative gross-hours divisor	Planning

Blended rate = (pharmacist share × pharmacist wage + technician share × technician wage), times (1 + benefits load) on the fully-loaded basis. Effective minutes per PA blends your manual time with a 4-minute ePA time by your electronic share. Base processing cost = monthly PAs × 12 × effective minutes ÷ 60 × blended rate. Denial rework = annual PAs × denial rate × rework minutes ÷ 60 × blended rate. Total annual PA labor burden = base processing + denial rework. Reclaim scenarios apply a 50 / 70 / 85% reduction to total PA hours. PA volume is your input because published per-pharmacy volume is unreliable. Wage data is the national mean; hospital and clinical pharmacists often run higher, so set your market. Sources: Surescripts, BLS OEWS (latest), BLS ECEC.

Your inputs

Assumptions last reviewed: June 2026

This is a planning model, not a budget or a quote.

It is built for scenario modeling and early business cases. Validate the assumptions against your actual numbers before using the estimate for budgeting or vendor decisions.

Your real monthly PA volume and the manual vs. ePA split
Local pharmacist and technician wages, not the national mean
Your benefits/employer load (default 30%)
Your actual denial rate and rework time per denial
Whether techs or pharmacists truly do each PA step
State board and payer rules that affect who can process PAs

TheraIntel · theraintel.com · Prior Authorization Burden Calculator. This is a planning estimate generated from your inputs and the cited default assumptions, not a budget, audit, or vendor quote. Assumptions last reviewed June 2026.

That number is a line item you can shrink.

Bring your result. We will pressure-test the assumptions against your real volume, wages, and denial data, and turn it into a board-ready staffing or ROI model.

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