How a High-Volume Urology Practice Rebuilt Prior Authorizations for Scale
EXECUTIVE SUMMARY
Prior authorizations are a persistent operational strain for specialty practices, particularly those with high surgical and imaging volumes.
One high-volume urology group partnered with Advantum Health to offload authorization workflows and gain operational visibility through Advantum One, an AI-powered authorization solution supported by experienced operational teams.
By fully outsourcing prior authorizations and integrating with their existing electronic health record (EHR), the practice eliminated internal authorization work, reduced staffing pressure, and built a scalable model that supports continued growth. This engagement transformed prior authorizations from a bottleneck into a controlled, measurable, and scalable process.
THE CHALLENGE
Before partnering with Advantum Health, prior authorizations at the urology group were handled internally by leadership and operational staff. As authorization volume increased, the work outpaced available capacity, creating operational strain and limiting visibility into authorization status.
In addition to workload pressure, the organization lacked centralized reporting or dashboards to track authorization progress. Without consistent data or standardized workflows, it was difficult to monitor turnaround times, identify potential risks, or plan for growth without adding staff.
“Prior authorizations had become increasingly manual and time-consuming. Staff spent significant time on phone calls and payer requirements, which slowed approvals and pulled resources away from other operational priorities.”
Director of Operations
THE RESULTS
Advantum Health assumed responsibility for the full authorization lifecycle, including submission, payer follow-up, and issue resolution, across a broad range of authorization types, including urologic surgeries and radiology procedures.
The team integrated directly with the practice’s existing electronic health record, Modernizing Medicine (ModMed), allowing authorizations to be initiated, tracked, and resolved within established systems.
Within 45 days of go-live, the practice gained structured reporting and dashboard visibility into authorization status and volume, delivering a level of operational insight that had not previously existed.
- Authorization workload reduced to less than one full-time equivalent (FTE)
- Authorization-related denials or appeals eliminated
- Reporting and dashboard live within 45 days
- Internal authorization work eliminated
Why This Scales
Centralized workflows and standardized payer logic support growth without incremental headcount.
“The partnership has had a clear operational impact. With prior
authorizations off our team’s plate, staff are able to focus on their
core responsibilities and patient care, and turnaround times
have improved. The Advantum Health team has been consistent
and dependable.”
Director of Operations
High-Volume Urology Practice
Prior authorizations don’t have to be a growth limiter. With the right combination of technology and experienced operational teams, they can become a controlled, scalable process.
Have questions or want to explore what a scalable authorization model could look like
for your practice? Let’s talk.