06/14/2026
A doctor orders a basic antibiotic for a sinus infection. The drug costs a few dollars. Then the denial hits.
Not because the medicine is wrong. Because the insurer covers tablets, not capsules. Same drug. Same dose. Same patient. One word on the script and the whole thing stops.
So now what happens?
The patient drives to the pharmacy, gets turned away, and goes home empty-handed. The doctor has to call the insurer, find out why, call the pharmacy, change the order, then track down the patient to say "go back and try again." The pharmacist re-does the work.
Everybody's time gets burned. For nothing.
This is prior authorization. The "cost control" tool that controls nothing except your access.
Here's what it actually costs the system:
→ Doctors handle ~39 prior auths a week, burning ~13 hours of staff time on paperwork instead of patients (AMA, 2024).
→ 40% of practices now pay people to do nothing but fight insurers.
→ ~95% of physicians say it fuels burnout.
→ Around $35 billion a year in administrative spending nationwide.
And the patient? That's the part nobody talks about.
→ ~80% of doctors say prior auth leads patients to abandon treatment they were prescribed.
→ Up to 1 in 3 patients who hit a prior auth at the counter never come back for the medicine — even after the doctor wins the appeal.
Think about that. The drug was cheap. The doctor knew what to prescribe. The pharmacist knew how to fill it. The only thing standing between the patient and getting better was a middleman adding cost, delay, and zero value — so they could justify their seat at the table.
That's not managing care. That's taxing it.
So we did the obvious thing. We fired them.
No PBM. No prior auth games. No "your insurance prefers a different pill." Just a transparent cash price you can see before you ever walk in, cost-plus instead of markup, and your medication without a permission slip.
The system is broken on purpose. You don't have to stay in it.
