If you’ve ever waited to pick up a prescription only to be told it’s on hold for “prior authorization,” you’re not alone — and it can be frustrating. Whether you’re a patient waiting for relief or a provider trying to help your patient get the care they need, prior authorization (PA) delays can cause confusion and stress.
So, let’s answer the big question: How long does prior authorization take for medication? And more importantly, what can be done to speed up the process?
What Is Prior Authorization?
Prior authorization is when your health insurance company requires your doctor or provider to get approval before they’ll cover a medication, procedure, or service.
Think of it as your insurer saying, “Before we pay for this, we want to make sure it’s really necessary.” It’s most commonly used for expensive medications, brand-name drugs, or newer therapies — but can apply to procedures and imaging too.
How Long Does Prior Authorization Usually Take?
Here’s what to expect:
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For medications:
Most insurance companies respond to prior authorization requests within 24 to 72 hours, especially for urgent prescriptions. However, some may take up to a week or longer depending on the insurer, the medication, and whether more documentation is needed. -
For procedures or surgeries:
If you’re wondering how long doctor pre-authorization takes for a procedure, the timeline is often 3 to 10 business days, though urgent requests can be processed faster. -
For specialty drugs:
These often involve more complex reviews and may take 5 to 14 business days.
⏱️ In short: It can take anywhere from a few hours to a couple of weeks.
Why Does My Insurance Need to Approve a Prescription?
Insurance companies use prior authorization to:
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Ensure medications are being used appropriately
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Encourage the use of generic or lower-cost alternatives
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Manage costs across large patient populations
While the intent is cost control, it can delay treatment — especially when patients are in urgent need.
How to Speed Up Prior Authorization for Medication
Waiting on a prescription can be frustrating, but there are ways to move things along. Here’s how to speed up the process:
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Ask Your Pharmacy for Updates
Pharmacists often know exactly where a request stands and can tell you if the doctor needs to provide more info. -
Call Your Doctor’s Office
Politely check in and ask if the prior authorization was submitted. In some cases, the delay is in getting the paperwork started. -
Request Electronic Prior Authorization (ePA)
Electronic submissions are faster than faxing or calling. Ask if your provider uses ePA tools — many modern offices do. -
Submit All Documentation Early
If you’re a provider, submitting chart notes, diagnosis codes, and medication history upfront can reduce back-and-forth with the insurer. -
Know Your Plan’s Prior Authorization Rules
Different plans have different requirements. Make sure you or your office staff know exactly what your insurer needs to approve a drug or procedure.
When a Doctor Refuses to Do a Prior Authorization
In rare cases, a patient may hear that their doctor refuses to do prior authorization. This can happen due to time constraints or administrative burden. If this happens:
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Ask if another staff member can handle it, such as a medical assistant or billing coordinator
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Request a referral to a specialist who’s familiar with the process
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Contact your insurance company directly — they may be able to suggest covered alternatives
At Prospect Healthcare Solutions, we help providers streamline the prior authorization process, so it doesn’t become a barrier to care.
Final Thoughts
So, how long does prior authorization take for medication? It depends — but delays of 2 to 7 days are common. For procedures, it could be longer. While the system isn’t perfect, there are ways to reduce wait times and improve communication between providers, insurers, and patients.
At Prospect Healthcare Solutions, we specialize in helping practices manage insurance requirements efficiently — from prior authorizations to billing and claims. We know how frustrating it can be when red tape gets in the way of patient care, and we’re here to help you cut through it.
Need help navigating prior authorizations or improving your medical office workflow?
Contact us today to learn how we support providers and patients with smarter healthcare solutions.
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