A biller at a single-location practice I work with tracked her time for a week. Not because I asked. Because she had a feeling, the kind that builds up over a few months of Monday mornings, that more of her workday was going toward carrier portals than was going toward actual billing. She tracked it for five days and then sent me a spreadsheet.

Sixty-four portal sessions in a week. Not sixty-four eligibility checks. Sixty-four times she navigated to a carrier portal, entered credentials, waited for a one-time code, and got in. Or tried to get in. Delta Dental sent the code to a front desk phone three times during those five days; the front desk was occupied with patients each time. She waited. UnitedHealthcare logged her out after eighteen minutes of inactivity. She logged in again. One Aetna session failed on the first attempt, and after the second failed attempt she got a warning that a third would lock the account. She stopped. She called Aetna's provider line and spent nineteen minutes on hold.

At the bottom of the spreadsheet she wrote: "I am not complaining. I just want to know if this is what everyone deals with."

It is. And nobody has put a number on it.

What you are paying for, exactly

Every carrier portal your biller accesses carries what I call the authentication tax. It is not the work of verifying a patient's benefits or chasing down a claim status. It is the overhead the portal collects before it lets her do the work: the login sequence, the wait for the one-time code, the re-login after the session expired, the relay through whoever happens to have the phone the code went to this time.

The reason this tax goes unmeasured is structural. Your billing software has fields for claims submitted, denial rate, A/R aging, days in A/R. None of those fields has a column for "minutes waiting on a one-time code." Your biller's salary is a salary line. What she is doing inside that salary is invisible to any report you run.

The carriers have no incentive to fix this. The friction of their session management lands entirely on your practice, not on them. A fifteen-minute session timer on a portal that requires a one-time code at every login is not an oversight. It is the natural outcome of a system designed for carrier convenience, not provider efficiency.

The portals your practice actually deals with

A single-location practice participating in standard PPO plans typically accesses, at minimum, six carrier portals: Delta Dental, Aetna Dental, Cigna Dental, MetLife, UnitedHealthcare Dental, and Guardian. Add the state Blue Cross Blue Shield dental plan or plans your area requires, and you are often at eight or nine. Some practices dealing with Medicaid patients are logging in to state Medicaid portals as well, each with their own credential and one-time code system.

None of these portals were designed to work together. None of them shares session state. Each one independently decides how long your biller stays logged in, where the one-time code goes, and how many failed attempts before the account locks.

The math

Here is the calculation I run with practices to show them what they are paying.

I will use $22 per hour as the biller's cost. The Bureau of Labor Statistics Occupational Employment and Wage Statistics program puts the median hourly wage for billing and posting clerks in healthcare settings at approximately $21 to $23 per hour, depending on geography. Twenty-two is at the conservative end.

For portal session counts at a busy single-location practice seeing 15 to 20 patients per day:

Forty to fifty sessions per week for eligibility verification. Not all eligibility checks require a portal pull. Practices using clearinghouse-based 270/271 feeds will handle some of this upstream. But any patient whose remaining benefits need verification, whose last-visit date matters for the benefit calculation, or whose coverage has changed since the last visit requires a portal check. Clearinghouse feeds cannot give you that. For most practices with an active recall schedule, that is a meaningful fraction of daily patients.

Twenty to twenty-five sessions per week for claim status. Claims sitting at 30 or 60 days need to be followed up at the portal.

Ten to twelve sessions per week for payment reconciliation, EOB pulls, prior authorizations, and miscellaneous lookups.

Total: call it eighty sessions per week.

Now apply two session types.

A clean session, meaning credentials work on the first attempt, the one-time code arrives in under 90 seconds, and the session has not already expired, costs roughly two minutes of authentication overhead.

A friction session, meaning the code went to the wrong phone, or the session had already timed out, or the first attempt failed and triggered a lockout warning, costs roughly nine minutes. That accounts for the wait, the relay, the retry, and the occasional hold with a carrier support line.

From watching billers work across practices, roughly one in four sessions has at least one friction event. This is not a reflection of the biller's competence. It reflects session management decisions made by carrier portal engineering teams.

Sixty clean sessions times two minutes: 120 minutes.

Twenty friction sessions times nine minutes: 180 minutes.

Total: 300 minutes per week. Five hours of authentication overhead.

At $22 per hour: $110 per week. $476 per month. $5,720 per year.

This counts only the biller's direct time. It does not count the one-time code relay work that falls on everyone else in the office. When a code goes to the front desk phone and the front desk coordinator has to step away from a patient to read the code to the biller, that interruption has a cost. When the office manager has had her personal cell phone set as the one-time code destination for three portals since 2022 and no one has updated it, the time it takes to find her every time is a cost. Those costs are spread across multiple people and do not appear in any single person's time log, which is most of why they stay invisible.

The range I see across single-location practices is $5,000 to $8,000 per year in direct biller time, higher for practices with more portals or credential setups that have accumulated friction over several years.

What the number multiplies into at multiple locations

At a five-location group, you have either five billers or a central billing team doing the portal work for all five locations. Centralization does not reduce the authentication overhead. It often increases it, because the one-time codes still go to phones at individual offices. The central biller is now calling offices to get codes the same way the solo biller called the front desk, except she is doing it for five offices at once.

At five locations, $5,000 to $8,000 per year per location is $25,000 to $40,000 per year in authentication overhead. That number is roughly a full-time administrative position.

What the overhead is actually a tax on

Six hundred dollars per month, at a single-location practice, is not what makes or breaks the practice. The more interesting number is what five hours per week of recovered biller time would actually buy.

When I ask billers what they would do with five hours back each week, the answer is never "go home early." The answer is always specific. The 90-plus-day A/R bucket that she keeps meaning to work through. The denial that got written off as too complicated to be worth the appeal time. The patient balance aging reports that nobody has reviewed in two months because the week fills up before she gets to them.

The authentication tax is not just a labor cost. It is a claim throughput cost. The work that does not happen because Monday morning eligibility ran long is the denial that ages past the appeal window. It is the A/R that ends up written off instead of collected. Five recovered hours of biller time is not five hours of overhead savings. It is five hours of revenue recovery.

What Unify does about it

I built Unify because I had this conversation too many times. Billers who were clearly capable of higher output were spending five or six hours per week inside authentication loops they could not control.

Unify handles credentials and one-time code routing for over 350 dental carrier portals. When your biller opens a portal through Unify, Unify submits the credentials and routes the one-time code automatically. She does not wait for a code to arrive. She does not call the front desk. She does not re-login after a session times out. The portal opens.

The credential layer also stays in your hands, the owner's, not hers. That matters for reasons beyond authentication speed, including what happens if she ever leaves. But the authentication overhead is the place to start the conversation, because it is the cost you can measure.

If you want to run the math on your practice specifically, book thirty minutes with me here: https://calendly.com/tanner-unify/unify-demo. Bring your portal list and your biller's rough session count for a week. We will find out what your tax rate is.

The Delta Dental session timer varies by state plan. UnitedHealthcare's is twenty minutes. I know these numbers because we have built around them. Your biller knows them too. She just has not had a reason to add them up until now.