Case Study: a multi-specialty management services organization achieves 92-95% first-pass prior authorization approval with Staffingly's hybrid AI denial classification and PA routing

a multi-specialty management services organization lifts first-pass PA approval to 92-95% with Staffingly

The customer, a multi-specialty management services organization (mso), was struggling with inefficient denial management and prior authorization processes. After consolidating multiple acquired groups, their single, general queue led to first-pass approval rates below the industry benchmark and high costs. The mso partnered with vendor Staffingly to implement its hybrid AI denial classification and prior authorization routing service to address these challenges.

Staffingly's solution layered AI classification and routing on top of a team of specialty-trained billers. This hybrid approach resolved denials and routed prior authorizations with greater accuracy and speed. The results were significant, lifting the mso's first-pass approval rate to 92-95%, reducing the blended cost per prior authorization to under $4, and future-proofing their operations for upcoming CMS regulations.