How did Rocky Mountain Eye Center reduce prior authorization approval time?

Rocky Mountain Eye Center partnered with Manta Health to deploy AI-powered prior authorization automation for high-volume eye injection procedures. The platform standardized submission packages against payer-specific criteria, reducing average approval time from 11 to 12 days down to 2.8 days — a 75% reduction.

What denial rate did Rocky Mountain Eye Center achieve with Manta Health?

Rocky Mountain Eye Center achieved a net denial rate of 0.5% after appeals, with an initial denial rate of 1.9% — down from a pre-Manta rate of 3 to 10%. The platform's automated appeal generation, including AI-produced Letters of Medical Necessity, drove a high appeal success rate.

How much did Rocky Mountain Eye Center reduce prior authorization staffing?

Rocky Mountain Eye Center reduced its prior authorization team from five specialists to one, achieving 80% PA resource optimization. Manta Health's AI automation handled submission, tracking, denial determination, and appeal generation — freeing staff to focus on patient care rather than administrative follow-up.

What is the financial impact of prior authorization denials on ophthalmology practices?

Prior authorization denials in ophthalmology create revenue leakage through three primary channels: care downgrades to cheaper treatments, patient drop-offs due to delays, and claims write-offs on unsuccessfully appealed denials. Rocky Mountain Eye Center estimated losses of up to $113 per injection patient before deploying Manta Health's coverage intelligence platform.

How does Manta Health handle high-volume anti-VEGF prior authorizations?

Anti-VEGF treatments such as Eylea, Lucentis, and Avastin require prior authorization for nearly every injection, with payer-specific step therapy requirements and frequently changing biosimilar policies. Manta Health automates the determination, documentation, and submission for each injection authorization, tracks step therapy compliance across treatment history, and stays continuously updated on payer rule changes. This is the workflow that drove Rocky Mountain Eye Center's 75% reduction in approval time and 0.5% net denial rate.

Case Studies

min read

Rocky Mountain Eye Center Reduces Prior Authorization Approval Time by 75%

Manta Health reduced prior authorization approval time by 75% and achieved a 1.9% net denial rate through AI-powered automation.

Conor Foley

December 15, 2025

Rocky Mountain Eye Center Reduces Prior Authorization Approval Time by 75%

Table of contents

The Challenge
The Solution
The Results
Conclusion

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75%

Faster Approvals

1.9%

Net Denial Rate

80%

PA Resource Optimization

Performance Summary

Metric	Pre-Manta	With Manta	Impact
Approval Time	11–12 Days	2.8 Days	75% Reduction
Initial Denial Rate	3%	1.9%	Precise Submission
Net Denial Rate	3%	0.5%	High appeal success
Staff Optimization	5 PA Specialists	1 PA Specialist	Resource Optimization

Source: Internal performance data provided by Rocky Mountain Eye Center, 2025–2026.

The Challenge: The Crippling Cost of Traditional Prior Authorizations

Rocky Mountain Eye Center, a leading provider of comprehensive eye care, was struggling with the high administrative and financial burden of securing prior authorizations (PAs) for critical, high-value eye injections. Like many specialty practices, Rocky Mountain Eye Center wasn’t losing revenue at billing; it was losing it upstream, during coverage verification and prior authorizations.The traditional PA process was characterized by manual data collection, lengthy back-and-forth with payers, and inconsistent denial appeals, resulting in four major areas of loss:

Inefficiency and Delayed Care

Long Cycles: The manual submission process led to unacceptably long PA approval times, delaying life-altering treatment for patients with conditions like Macular Degeneration and Diabetic Retinopathy.
High Overhead: Significant administrative staff time was consumed by following up on submissions and chasing down necessary clinical documentation.

Stopping Revenue Leakage: The Financial Cost of PA Denials

When PAs were denied or significantly delayed, RMEC faced immediate, measurable revenue losses:

Care Downgrades: Patients, due to delays or insurance pressures, were often switched from optimal treatments (like Eylea or Lucentis) to cheaper, less effective alternatives (like Avastin).
- Financial Impact: Loss of $1,070 in profit per patient who moved to a cheaper treatment.
Patient Drop-Offs: The frustration and delay of the PA process caused some patients to abandon treatment entirely or seek care elsewhere.
- Financial Impact: Loss of $3,000 in profit per patient drop-off.
Claims Write-Offs: Denials that were not successfully appealed resulted in uncompensated care.
- Financial Impact: Loss of $5,000 per denied claim written off.

Individually, these issues appeared manageable. In aggregate, they created continuous revenue leakage before a claim was ever submitted. Pre-Manta Health Annual Financial Leakage: RMEC was losing an estimated $113 in profit per patient receiving an eye injection at the practice if you average out the total losses above across all injection patients.

The Solution: Scaling Efficiency with Prior Authorization Automation

RMEC partnered with Manta Health to deploy its end-to-end AI Prior Authorization solution, focusing specifically on high-volume eye injection PAs. The goal was to remove human touch points, speed up approvals, and ensure a near-perfect submission and appeal rate.

Key Features Deployed:

Achieving Touchless Approvals through AI Optimization: The AI engine standardized and optimized every submission package to automatically meet payer-specific criteria, driving a high rate of initial, touchless approvals and ensured every submission met payer-specific requirements upfront.
At Manta Health, we define Touchless Approvals as prior authorizations that are submitted, processed, and approved by payers without requiring manual intervention from administrative staff.
AI Denial Determination: For any initial denials, the Manta Health platform immediately identified the exact reason for the denial and determined the optimal appeal strategy.
Automated Appeal Generation: The platform automatically generated all necessary appeal documentation, including a highly detailed Letter of Medical Necessity (LOMN) and updated clinical records, reducing the appeal process from weeks to days.

The Results: Speed, Autonomy, and Significant Revenue Recovery

Manta Health helped RMEC achieve immediate and dramatic improvements across all key performance indicators (KPIs).

Average Time to Approval: 2.8 days (Reduced approval time by over 75%)
Denial Rate: Reduced from 5–10% to 2% (90% improvement)
Eye Injections Managed: 100%

Financial Impact Summary:

By leveraging Manta Health, RMEC saw a 71% financial recovery on the challenged areas.

Administrative Burden: 65% decrease in labor costs from doing PAs in house to using Manta.
Care Downgrades due to denials (Switching to Avastin): 81% reduction in care downgrades
Patient Drop-Offs Due to Denials: 75% decrease in patient drop off
Claims Write-Offs: 80% reduction in PA related claims drop offs

These results reflect a side-by-side comparison of RMEC’s manual historical records against performance data captured within the Manta Health platform during the pilot period.

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Final Thoughts

Optimal Care and Optimal Revenue

The partnership between Rocky Mountain Eye Center and Manta Health transformed a costly, time-consuming administrative function into a nearly fully autonomous revenue driver.

The 90% drop in denials and average approval time of under 3 days mean RMEC's administrative staff are now free to focus on patient care instead of paperwork. Crucially, the virtual elimination of profitable revenue leakage ensures patients receive the **best possible care** without financial or bureaucratic obstacles.

Manta Health stands behind the accuracy of the performance metrics shared in this case study, which were validated by the administrative leadership at Rocky Mountain Eye Center.