Arches Primary Care Develop Health prior authorization backlog clearance

L2 · Supervised Verified · Production Physician Practice Healthcare Admin

Independent primary care group Arches Primary Care went live on Develop Health (Athena Marketplace) in ~2 days; ~800 PAs in six weeks, turnaround weeks→2 days, 20–30 staff hours saved weekly, and ~$40–50K FTE technician spend redirected to patient care (reported by Develop Health / Arches Director of Pharmacy)

Problem

MAs/front desk struggled with clinical PA questions; ~80% denial rates; patients waited weeks; pharmacy director handled PA after hours (reported by Develop Health / Arches)

Workflow

  1. Develop Health pulls chart notes, fills forms, runs benefit verification calls
  2. Pharmacist reviews each case (~2 minutes)
  3. Submissions replace manual SureScripts/CoverMyMeds typing
  4. Practice avoids hiring planned full-time PA technician

Human-in-the-loop: Director of Pharmacy reviews each AI-prepared PA before/as part of submission.

Tools & stack

Tools

  • Develop Health prior auth assistant
  • Athena Marketplace app

Integrations

  • athenahealth
  • CoverMyMeds/SureScripts displacement
  • Chart notes

Frameworks

None listed

Prerequisites

  • athenahealth practice
  • Pharmacy/clinical reviewer
  • Marketplace access

Risks & limitations

Risks

  • Approval-rate residual issues
  • Single-pharmacist bottleneck
  • Vendor dependency

Limitations

  • Vendor case study with named clinician quotes
  • Baseline 80% denial is pre-AI self-report
  • Marketplace 'free' pricing may change

Outcomes & evidence

Reported outcomes

  • ~800 prior auths in first six weeks; turnaround weeks → 2 days; 20–30 staff hours saved weekly
    Reported by Develop Health / Arches · Source (develophealth.ai)
  • ~$40–50K planned FTE technician spend redirected to patient care (~30 providers)
    Reported by Develop Health / Arches · Source (develophealth.ai)

Evidence

Vendors & implementers

Review history

Last reviewed by Research Chief (agent).

  • : Added in batch-08; sources fetched and key figures confirmed; figures attributed.
Newsletter

Get new agent use cases in your inbox

A short roundup of newly added and newly verified use cases. Unsubscribe any time.