New Data from Silna Shows Prior Authorization Reform Has a Blind Spot

Silna data finds partial approvals affect 1 in 6 therapy authorizations and no one has to report it

NEW YORK, NY, UNITED STATES, June 30, 2026 /EINPresswire.com/ -- Silna, a healthcare technology company redefining how providers navigate prior authorization, today released data that challenges the way the industry understands the prior authorization problem.

The prior auth debate has been built almost entirely around denial rates: how often payers say no, and how to reduce that number. Silna's analysis of 158,000 authorization requests for physical therapy, occupational therapy, and speech therapy across two of the largest Medicare Advantage payers in the country tells a different story. The outright denial rate across those requests was 0.9%. But 1 in 6 requests came back approved with fewer therapy sessions than the physician originally prescribed.

Because it's technically an approval, a partial approval doesn't appear in denial rate reports, so payors aren't required to disclose it, while providers can't appeal it as a denial. It registers as a successful authorization in every metric the industry uses to measure itself, while the patient receives less care than their doctor ordered.

The rate of partial approvals was nearly identical across all three therapy disciplines:

-- Physical therapy: 15.3% of authorizations returned with reduced units
-- Occupational therapy: 15.6%
-- Speech therapy: 16.8%

Physical therapy, occupational therapy, and speech therapy are among the highest-volume therapies in post-acute care, and all three show the same pattern. When a payor cuts a therapy authorization from 20 sessions to 12, or reduces sessions for a patient recovering from a stroke, the downstream effect is clinical. Patients are discharged before they're ready, or don't complete the course of treatment their physician prescribed. None of that shows up in the numbers that reform advocates are tracking.

"The prior auth debate has spent years focused on denial rates," said Jeffrey Morelli, Co-Founder and CEO of Silna. "Our data shows the denial rate is almost a distraction. When 1 in 6 therapy authorizations comes back with reduced units and nobody is required to report it, the denial rate tells you almost nothing about what's actually happening to patients."

HealthPRO Heritage, which operates across 48 states and serves patients in skilled nursing, senior living, and hospice settings, is working with Silna to surface and address partial approvals before they affect patient care.

“We see partial approvals constantly. A patient gets approved, the care team builds around that plan, and then the payor quietly cuts the sessions,” said Kevin Murphy, VP of Revenue Cycle at HealthPRO Heritage. “The patient just gets less care than their doctor ordered and nobody has to answer for it. Partial approvals are the hidden tax nobody in the industry is tracking, and our patients can’t afford to keep paying it.”

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About Silna
Silna is building the industry's first Care Readiness Platform to transform healthcare's most complex administrative processes, such as prior authorization, benefit checks, and real-time insurance monitoring. Since coming out of stealth in 2025, the platform has reduced the time required for pre-visit processes, such as insurance verification, from 30 minutes to 30 seconds. Based in New York City, Silna is backed by leading investors, including Accel, Bain Capital Ventures, and more.
For more information, visit silnahealth.com.

Kamila Khasanova
On Top Strategy
kamila@ontopstrategy.com

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