New data from just under one million lab-based cases reveals systemic inefficiencies and rising denial rates, underscoring the urgent need for scalable, provider-focused solutions
VIENNA, Va., June 17, 2025 -- careviso, a leader in healthcare technology solutions and prior authorizations (PA), today released the findings of its extensive 2024 audit, offering a significant look at the continued complexity, delays, and inefficiencies in the PA process across the U.S. diagnostic ecosystem.
With just under one million prior authorization requests analyzed, careviso's audit highlights what clinicians and patients alike have long known: while prior authorization was designed to ensure appropriate use of services and manage healthcare costs, its implementation today often introduces administrative hurdles that can delay care and increase provider burden.
careviso's 2024 audit paints a clear picture of operational friction within the healthcare system. While many cases moved efficiently through the system, challenges remained. Just over three-quarters of all cases resulted in either an approval or were determined not to require prior authorization, demonstrating the value of precise documentation and payor connectivity. However, approximately one-quarter were denied, and a notable portion required administrative follow-up before a decision could be rendered-adding complexity and delay to already time-sensitive clinical workflows.
The audit also found that most cases were resolved in an average of 5.5 days —time that, while faster than industry norms, can still translate to delayed patient treatment, rescheduled appointments, and administrative stress on care teams.
Among the most frequently cited denial reasons:
- Services were not provided or authorized by network providers (Codes 242 & 243)
- Information from the rendering provider was missing or incomplete (Code 226)
- Procedures were deemed investigational or not covered by benefit plans (Codes 55 & 204)
These denials reflect a broader reality: even when care is appropriate, authorization can be denied due to data gaps, benefit limitations, or payer policies—resulting in cascading effects for providers and patients alike.
As healthcare costs shift further to patients, care teams need tools that remove administrative friction. careviso's seeQer platform delivers just that: a faster, more efficient prior authorization process that enables providers to focus on patient care, not paperwork. Importantly, the company maintains secure connectivity to payers through partner agreements—without supporting their operations directly.
"Our aim has always been to support the provider and facility," said Andrew Mignatti, CEO of careviso. "We've developed scalable technology to automate and simplify prior authorizations, and while we've achieved significant growth, we've done so without compromising accuracy or transparency."
While much national attention has focused on healthcare price transparency, careviso's audit reveals that administrative processes like prior authorization are equally deserving of reform. Delays in authorization not only stall care but also erode patient trust, adding anxiety to already difficult health journeys.
careviso's April 2025 survey of 2,500 U.S. patients found that 81% reported PA requirements had delayed or disrupted their access to care. While legislative steps toward transparency have been introduced, this latest data underscores that meaningful modernization requires digital solutions that address both cost clarity and operational efficiency.
careviso's vision for modernizing the prior authorization process centers on provider support, not payer compliance. Its proprietary seeQer platform allows providers to receive real-time updates, improve documentation accuracy, and close the loop faster—empowering labs and clinicians to deliver care without second-guessing administrative decisions.
As the system evolves, careviso remains committed to removing the noise from healthcare operations, helping providers navigate payer protocols while staying focused on what matters most: delivering high-quality, timely care to patients.
About careviso
Founded in 2018, careviso is dedicated to transforming the healthcare experience by streamlining prior authorizations and enhancing financial transparency. With a focus on innovation and efficiency, careviso's platform helps healthcare providers and patients navigate the complexities of healthcare access and costs. To date, careviso has successfully completed over 2 million prior authorizations and 1 million financial transparency transactions, underscoring its role as a trusted partner in healthcare.
For more information
Justin Baronoff
Merit Mile
561-362-8888 – office
407-340-2247 – mobile
jbaronoff@meritmile.com
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