Clinical Capacity Consumed by UR Tasks Instead of Billable Mental Health Care

$100,000 - $150,000 annually (1.5-2 sessions/week delayed per clinician; school-based contracts often lower reimbursement, so cash flow timing matters more) • $100,000-$160,000 annually (1-2 sessions/week delayed × $130 × 52 weeks × 15 LPCs, plus 6% EAP denial/appeal workload) • $120,000 - $180,000 annually (1-2 sessions/week displaced by dual compliance/auth tasks; court-mandated population average session length 90+ days, so denied auth cascades into 20-30 lost sessions per denied case)

Administrator manually reviews denial logs, sends email alerts to clinicians, tracks UR staffing gaps via spreadsheet, uses outside billing consultants for appeal management • Administrator manually tracks VA authorization timelines, calls VA directly to expedite, coordinates with clinicians via phone/email, tracks unfunded bed-days via spreadsheet • Administrator pulls manual productivity reports, cross-references with denial logs via separate systems, manually calculates lost session estimates, engages external UR audit support