Staffingly Releases 2026 Prior Authorization Burden Report Revealing Critical Medicare Appeal Gap
Staffingly, Inc., a healthcare outsourcing company specializing in administrative support for medical practices, has announced the publication of its 2026 Prior Authorization Burden Report, a comprehensive benchmark study examining the current state of prior authorization across the United States. Built on 74 independently verified statistics from trusted public sources, the report provides healthcare organizations with evidence-based insights as new federal prior authorization requirements begin taking effect in 2026.
The report draws exclusively from named primary sources, including the Centers for Medicare & Medicaid Services (CMS), the American Medical Association (AMA), KFF, and the U.S. Department of Health and Human Services Office of Inspector General (HHS OIG). Each statistic is verified against its original source and presented with supporting charts, methodology notes, a machine-readable data appendix, and a downloadable PDF for healthcare professionals and policymakers.
One of the report’s most significant findings is what Staffingly calls the “appeal gap.” According to the analysis, 80.7% of appealed Medicare Advantage prior authorization denials were partially or fully overturned in 2024, yet only 11.5% of denied requests were ever appealed. In a separate finding cited from the HHS Office of Inspector General, 13% of denied requests actually met Medicare coverage requirements, highlighting opportunities for practices to recover otherwise lost reimbursements through more effective appeals management.
The report is being released as healthcare providers prepare for implementation of the CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F), which begins taking effect in 2026. While the rule is expected to improve response times and increase transparency, Staffingly’s analysis concludes that it does not significantly reduce the documentation burden placed on medical practices during the prior authorization process.
“Every number in this report traces to a named public source, from CMS to the American Medical Association to the HHS Inspector General,” said Dan Nandan, Founder and CEO of Staffingly, Inc. “The pattern that should stop people is the appeal gap. When practices challenge a Medicare Advantage denial, they usually win, and yet almost no one challenges.”
The report arrives at a critical time for healthcare organizations. According to data referenced from the AMA’s 2025 physician survey, physicians spend an average of 13 hours each week managing approximately 40 prior authorization requests, while 26% of physicians reported a serious adverse event linked to prior authorization delays. These growing administrative demands continue to strain physician practices, revenue cycle teams, and patient care operations.
Staffingly believes the report provides practical value beyond policy discussions by giving medical practices objective benchmarks they can use to evaluate their own authorization processes, staffing requirements, and appeal strategies. By quantifying national trends with verified public data, healthcare organizations can identify operational gaps, allocate resources more effectively, and prepare for the ongoing documentation requirements that remain despite regulatory modernization.
Medical practice owners, administrators, revenue cycle managers, healthcare journalists, and policy analysts are expected to find the report particularly valuable as they assess the evolving impact of prior authorization reform and identify opportunities to improve operational efficiency while maintaining patient access to care.
The full report is available online as a free public resource, enabling healthcare organizations to access transparent data, supporting documentation, and benchmark metrics that can inform operational planning and strategic decision-making.
About Staffingly, Inc.
Staffingly, Inc. is a healthcare outsourcing company that provides administrative support services to medical practices nationwide, including prior authorization, insurance verification, revenue cycle management, and virtual medical assistants. Working within clients’ existing systems during U.S. business hours under signed Business Associate Agreements, Staffingly helps healthcare organizations improve operational efficiency, reduce administrative burden, and strengthen revenue cycle performance while maintaining compliance with healthcare regulations.
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Company Name: Staffingly, Inc.
Contact Person: Dan Nandan
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Phone: 8004895877
Address:15 Corporate Place South Suite 145
City: Piscataway
State: NJ
Country: United States
Website: https://staffingly.com
