Cardiology Case Study
Heart and Vascular Associates: Prior Auth Approval from 65% to 94% and $320K Recovered
How a 5-cardiologist group eliminated the prior authorization bottleneck with 4 virtual specialists
Summary: Heart and Vascular Associates, a 5-cardiologist group in Atlanta, deployed 4 virtual medical assistants specializing in prior authorization, medical scribing, and referral coordination. In 12 months, first-pass prior authorization approval rose from 65% to 94%, turnaround time dropped from 14 days to 2.3 days, and the practice recovered $320K in annual revenue from procedures that were previously denied or delayed.
Practice overview
Specialty
Cardiology
Locations
2 locations in metropolitan Atlanta
Providers
5 cardiologists, 2 NPs
Annual revenue
~$9M
Engagement length
12 months and counting
Virtual staff deployed
4 virtual medical assistants
The challenge
Prior authorization approval rate was 65%, with 35% of imaging and procedure requests requiring appeals or resubmission.
Average prior auth turnaround was 14 days, delaying cardiac catheterizations and stress tests by 2 to 3 weeks.
Two clinical staff spent 3+ hours daily on authorization calls, reducing patient-facing time.
Referral follow-through was 58%, with many patients falling out of the referral loop before scheduling.
Roles deployed
Prior authorization specialists
Medical scribe
Referral coordinator
Total: 4 full-time virtual medical assistants at $14/hr
Outcomes
Prior auth first-pass approval
Complete clinical documentation submitted with every request, matching payer-specific criteria.
Prior auth turnaround
Dedicated specialists follow up daily and escalate stalled requests within 48 hours.
Recovered annual revenue
Procedures and imaging that were previously denied, delayed, or abandoned by patients.
Referral follow-through rate
Every referral tracked to scheduling; patients contacted within 24 hours of the referral order.
Before and after
| Function | Before | After |
|---|---|---|
| Prior authorization | 65% first-pass approval; 14-day average turnaround. | 94% first-pass approval; 2.3-day average turnaround. |
| Clinical staff time | Two clinical staff spent 3+ hours daily on auth phone calls. | Zero clinical time on auth; providers focus entirely on patient care. |
| Referral tracking | 58% follow-through; patients lost between referral and scheduling. | 91% follow-through; every referral tracked and patients contacted within 24 hours. |
| Documentation | Providers charted after hours; notes submitted 2 to 3 days post-visit. | Virtual scribe completes notes same-day; provider reviews and signs in minutes. |
“We were losing procedures to authorization delays. Patients would get frustrated waiting three weeks for approval and go to another cardiologist. Now we get approvals in two days and patients stay in our care.”
Managing Partner
Heart and Vascular Associates