Why Some Clinics Are Charging Fees for Prior Authorizations—and What It Means for Patients

Some medical practices are starting to charge patients extra fees for administrative tasks like prior authorization fees and letters of medical necessity. These are the approvals doctors must get from insurance companies before prescribing certain medications or treatments. For example, one clinic in Washington, D.C. now charges $50 per request, while others require an office visit just to complete the paperwork.

Doctors say the reason is simple: prior authorizations take a lot of time, often without reimbursement. Physicians may handle dozens of these requests each week, sometimes requiring long calls with insurance companies. This adds pressure on clinics and reduces time spent on patient care. Some practices are even considering switching to “concierge” models, where patients pay annual fees to cover administrative services.

However, charging patients directly comes with risks. Experts warn it could violate insurance contracts and may discourage patients from seeking necessary treatments due to extra costs. There’s also concern about negative patient reactions and increased inequality in access to care.

Organizations like the American Medical Association argue that the real solution is reducing unnecessary insurance barriers, not shifting costs to patients. While insurers claim they are improving the system, many doctors and patients remain skeptical.

Dall, C. (2026, March 31). Some physician practices charging patients for prior authorization work. MedPage Today. Read article