I am a 2-person, single physician office. My office administrator is also a clinician with her own caseload. It takes me 20 minutes to complete prior auth documentation at a minimum.

Denials of coverage for meds then takes [my] office admin 30-45 min on the phone to do appeals. I then have to spend more time to pull articles supporting use of the named med in given situations, pulling research on alternative treatments that have been shown to be less effective, etc., in order to provide support to the [prior authorization] appeal. I do not accept insurance, in part because a small office in psychiatry does not have the income to sufficiently support dedicated prior auth staff, insurance billing staff, etc., to deal with insurance loopholes and frustrations.