You see a patient. You make a clinical decision grounded in guidelines, history, and the person sitting in front of you. You place the order. And then, two days later, the prior authorization comes back denied. Not because your clinical reasoning was wrong. Because the note did not tell the story the reviewer needed to read.

Now you are spending 20 minutes reconstructing the justification you already had in your head during the visit. That is 20 minutes of unpaid after-hours labor, added to a workday that was already bleeding past 5 PM.