Quick summary: Most ophthalmology practices still send and receive a lot of their paperwork, referrals, prior authorization forms, insurance correspondence, by fax. That’s not a technology failure so much as a technology gap: the fax machine works, but nothing it produces is usable data until a person retypes it somewhere else. National data from CAQH puts a number on what that gap costs the industry. This piece covers what the data actually shows, where it hits eye care practices hardest, and what modernizing the fax step actually changes day to day.
Why eye care practices still run on fax
Fax survives in ophthalmology for a reason: it’s the one format every referring provider, every payer, and every hospital system can send and receive, regardless of what software they run. A retina referral from a primary care office, a prior authorization approval from a payer, an operative report requested by another practice, all of it can move by fax when nothing else is guaranteed to connect.
The problem isn’t that fax exists. It’s what happens after the fax arrives. A document lands as an image, not as data. Someone on staff has to open it, read it, and manually enter whatever’s inside into the practice’s EHR or billing system before it’s actually useful to anyone.
What the data says this actually costs
CAQH’s 2024 Index, drawn from more than 600 medical and dental organizations, put the annual cost of routine healthcare administrative tasks like insurance verification at $90 billion industry-wide, with $20 billion in savings still on the table if manual work shifted to fully electronic workflows. Practices using fully automated administrative processes saved an average of 70 minutes per patient visit. (CAQH, 2024 Index announcement) CAQH called out faxing medical records by name as one of the specific manual processes creating delays and straining provider resources. That’s not a vendor’s framing. It’s the industry’s own benchmarking organization saying it directly.
The American Academy of Ophthalmology’s advocacy page adds a specialty-specific data point: physicians and their staff typically spend the equivalent of two or more days a week negotiating prior authorization with insurers. (AAO, “Prior Authorization”) A meaningful share of that time isn’t spent deciding anything. It’s spent manually moving information that arrived on paper into a system that needs it typed in by hand.
Documo’s own 2025 survey of hospital administrators found that 88% say fax delays affect patient care, while only 29% have automated their fax workflow at all. (Documo, “Stuck in the Fax Lane,” 2025) The gap between those two numbers is the opportunity: almost everyone agrees this is a problem, and most organizations haven’t done anything about the specific step causing it.
CAQH’s Index has also priced out the difference at the transaction level. In its 2023 report, a manual prior authorization transaction cost providers an average of $10.97, compared to $5.79 for one handled electronically. Scaled across all transaction types (eligibility checks, claim status, prior authorization, and the rest), CAQH estimated the industry could save as much as $43.43 per patient encounter by conducting every transaction electronically instead of manually. (CAQH, 2023 Index) That’s not a one-time fix. It’s a per-encounter cost that compounds across every patient a practice sees.
What manual document handling does to staff, not just the schedule
The cost of manual document handling isn’t only measured in minutes and dollars. It’s measured in who’s left doing the work. The AMA’s most recent physician survey found that 95% of physicians say prior authorization contributes to burnout, and that on average, physicians and their staff spend 12 hours a week completing prior authorizations, on top of an average of 43 requests per physician, per week. (AMA, “Exhausted by prior auth, many patients abandon care,” 2024)
In an ophthalmology practice, that burden usually lands on the same handful of people: front desk staff, referral coordinators, and billing staff, who are also the ones fielding patient calls asking why a referral hasn’t been scheduled or why a procedure hasn’t been approved yet. Turnover in those roles is expensive to a practice in ways that don’t show up on a single line item: every departure means retraining someone new on a manual process that was already error-prone in the first place.
Where this shows up in an eye care practice
Three document types move through most ophthalmology practices constantly, and all three commonly arrive by fax:
Referrals. A cataract, glaucoma, or retina referral from an optometrist or primary care provider often arrives as a faxed page. Someone has to read it, confirm the reason for referral, and manually create the patient record before scheduling can even start.
Prior authorization paperwork. Anti-VEGF injections, certain glaucoma procedures, and some diagnostic imaging frequently require prior authorization. The request goes out, and often the payer’s response comes back the same way it went out: as a fax that has to be matched back to the right patient chart by hand.
Insurance and records correspondence. Requests for medical records, eligibility documentation, and correspondence with other providers still move by fax in a lot of practices, each one requiring someone to read it, route it, and often re-enter something from it.
Surgical scheduling packets. Cataract and other surgical cases typically involve a packet of documents moving between the practice, the surgery center, and sometimes an anesthesia group: clearance forms, history and physical exams, and consent paperwork. When these arrive by fax, staff have to manually confirm everything is present and correctly matched to the surgical date before the case can be scheduled with confidence.
DME and low vision device orders. Orders for durable medical equipment, low vision aids, and certain post-surgical devices often require the same manual paperwork trail as prior authorization, with a form going out and a fax coming back that has to be tracked down and matched to the right patient.
None of this is unique to eye care. What’s unique is how much of a practice’s day-to-day volume runs through exactly these document types, on top of a clinical schedule that’s already full.
What intelligent document processing changes
Intelligent document processing, IDP, doesn’t replace fax as a transmission method. It changes what happens the moment a fax arrives. Instead of landing as a static image that a person has to read and retype, the document gets automatically classified (referral, prior auth response, records request) and the relevant fields, patient name, date of birth, referring provider, reason for visit, get extracted and routed into the system a practice already uses.
The fax still comes in the same way it always has. What changes is that a staff member is reviewing and confirming information instead of retyping it from scratch.
What this looked like for one ophthalmology group
Eye Associates of New Mexico, a 15-location ophthalmology group, replaced a failing on-premise fax system with automated document intake. Per-document handling time dropped by more than 50%, inbound referral volume captured rose 25% in the first month, and the group’s IDP transition was tied to an estimated $3.6M in annual economic impact.
One 15-location ophthalmology group replaced a failing on-premise fax system with automated document intake. Per-document handling time dropped by more than 50%, inbound referral volume captured rose 25% in the first month, and the group’s IDP transition was tied to an estimated $3.6M in annual economic impact.
Why compliance can’t be an afterthought here
Every document type above carries protected health information, which means any modernization has to hold up to the same scrutiny as the systems it’s replacing. That means encryption in transit and at rest, audit trails on who accessed or touched a document and when, and a signed business associate agreement with whatever vendor is handling the intake. This isn’t a nice-to-have layered on top of automation. It’s the baseline a fax modernization approach has to clear before it’s worth evaluating on speed or cost at all.
What to look for when evaluating a fax modernization approach
A few questions tend to separate a real fix from a partial one:
- Does it actually reduce manual entry, or just move the fax somewhere digital? Routing a fax into an email inbox or a PDF folder is a smaller version of the same problem. The document still has to be read and re-typed by a person.
- Does it integrate with the systems the practice already runs on? A modernization approach that requires switching EHR or practice management systems is a much bigger project than the one being solved. Look for direct integration with what’s already in place.
- What happens when a document doesn’t classify cleanly? No system gets every document right automatically. What matters is how exceptions are surfaced for staff review, rather than silently misfiled or lost.
- Who’s accountable when something goes wrong? A dropped referral or a misfiled prior authorization has real consequences for a patient. Ask what the vendor’s own reliability and support track record looks like, not just what the software can technically do.
What modernizing this actually looks like
This doesn’t require replacing your EHR or changing how referring providers send you documents. The practices seeing the biggest difference are the ones that automated the single step causing the most rework: getting incoming faxes classified and entered automatically, so staff time goes toward reviewing exceptions instead of manual data entry on every single document.
In practice, that usually starts small: one document type, often referrals or prior authorization responses, moved into an automated intake process while everything else stays the same. Once that’s working, the same approach tends to extend naturally to the other document types moving through the practice, because the underlying problem, information trapped in a static image, is the same one each time.
Frequently Asked Questions
Why do healthcare practices still use fax if it’s inefficient?
Fax remains the one format every provider, payer, and hospital system can send and receive without needing compatible software. The inefficiency isn’t in sending the fax. It’s in what happens after it arrives, when a person has to manually read and re-enter the information.
What does intelligent document processing (IDP) actually automate?
IDP automatically classifies incoming documents (referral, prior authorization, records request) and extracts key fields like patient name, date of birth, and reason for visit, so staff review and confirm information instead of typing it in from scratch.
How much time does manual document handling cost a practice?
CAQH’s 2024 Index found that practices using fully automated administrative workflows saved an average of 70 minutes per patient visit compared to manual processes, and identified faxing medical records specifically as a source of delay industry-wide. CAQH’s 2023 Index separately found the industry could save as much as $43.43 per patient encounter by moving every administrative transaction from manual to electronic.
Does modernizing fax intake mean replacing the fax machine?
No. Fax stays as the transmission method every referring provider and payer already uses. What changes is what happens the moment a document arrives, whether it’s read and entered by hand, or automatically classified and routed.
Is this only relevant to large multi-location practices?
No. The specific document types (referrals, prior authorization, surgical scheduling packets) show up at every practice size. Smaller practices often feel the staffing impact more acutely, since the same one or two people are usually handling all of it.
