TL;DR: The ROI of automating refill requests for a NextGen practice comes from a simple formula: monthly refill volume times staff and provider minutes per request times loaded hourly cost, plus the cost of pharmacy callbacks, patient phone calls, and delayed renewals, minus what the automation costs. For a mid-to-large independent practice handling a few thousand refills a month, the labor alone usually adds up to more than one full-time employee. Payback depends mostly on your volume and how much of it is routine.
Why refill work is worth putting a number on
Refill requests are easy to overlook because each one is small. A nurse opens the task, checks the chart, confirms the last visit, glances at labs, and queues it for the provider. Three minutes, maybe four. Nobody budgets for it.
But the volume adds up, and it keeps growing. A longitudinal study in the Annals of Family Medicine found prescription messages per 8 hours of scheduled clinic time rose 19.5% between 2019 and 2023 for primary care physicians, while inbox time grew more than 24%. Specialty practices managing chronic medications see similar pressure.
Refill work also has a hidden multiplier. When a request stalls, the pharmacy sends another request, and the patient calls to ask why their medication isn't ready. One refill becomes two or three touches. Those duplicates are pure waste, and they rarely show up in anyone's staffing model.
If you're building a business case for your partners or board, you need to turn this into numbers. Here's how to do it with your own NextGen data.
The refill ROI formula
The core calculation has four parts.
1. Direct staff time: Monthly refill requests × minutes of staff time per request × loaded staff cost per minute
2. Provider time: Monthly refill requests × minutes of provider time per request × loaded provider cost per minute
3. Rework cost: Duplicate requests, pharmacy callbacks, and patient calls caused by delays × minutes per touch × loaded cost
4. Automation cost: Software fees + implementation effort + ongoing oversight time
ROI = (current cost of 1 + 2 + 3) − (remaining cost of 1 + 2 + 3 after automation) − 4
Automation doesn't drive any of these to zero. Exceptions still need a nurse, and providers still sign. The savings come from removing the research step on routine renewals and cutting the rework that delays cause.
How to pull each input from NextGen
You don't need a consultant for this. Two to four weeks of data from your own NextGen environment is enough for a credible model.
Refill volume. Count refill-related tasks in the Workflow module, including eRx renewal requests, plus phone, portal, and fax refill requests your staff log. If phone requests aren't logged consistently, sample a week by having the front desk tally them.
Staff minutes per request. Run a short time study. Have two or three nurses or MAs log start and stop times on a sample of 50 to 100 requests. Separate routine renewals from complicated ones, because they behave very differently.
Provider minutes per request. Providers are harder to time. Ask a few to estimate how long they spend per refill, or sample their approvals for a few days. Even 30 to 60 seconds per request matters at volume.
Unmatched and rerouted requests. Count how many eRx renewals needed manual matching and how many tasks moved between workgroups. These are your slowest requests.
Duplicates and callbacks. Look for repeat renewal requests for the same patient and drug within a few days, and ask the front desk to tally “where's my refill?” calls for a week.
Loaded cost. Use your own payroll data: salary plus benefits, payroll taxes, and overhead, divided by productive hours. Don't guess here. Your partners will ask where the number came from.
A worked example (illustrative numbers)
The numbers below are illustrative assumptions, not benchmarks or customer results. Replace every one with your own data.
Assumptions for an example mid-to-large independent practice:
- Refill requests per month: 3,000
- Staff time per request today: 4 minutes
- Provider time per request today: 1 minute
- Loaded staff cost: $36/hour
- Loaded provider cost: $180/hour
- Duplicate requests and refill calls: 15% of volume, 3 minutes each
- Share of requests automation can prepare as routine: 60%
- Staff time on prepared routine requests after automation: 0.5 minutes (a quick review)
- Provider time on prepared routine requests after automation: 0.5 minutes
- Reduction in duplicates and calls after automation: half
Current monthly cost:
- Staff: 3,000 × 4 min = 12,000 min = 200 hours × $36 = $7,200
- Provider: 3,000 × 1 min = 50 hours × $180 = $9,000
- Rework: 450 touches × 3 min = 22.5 hours × $36 = $810
- Total: about $17,000 a month, roughly $204,000 a year
After automation:
- Routine requests (1,800): staff 0.5 min, provider 0.5 min = 15 staff hours and 15 provider hours
- Exceptions (1,200): unchanged at 4 staff min and 1 provider min = 80 staff hours and 20 provider hours
- Staff: 95 hours × $36 = $3,420
- Provider: 35 hours × $180 = $6,300
- Rework: 225 touches × 3 min = 11.25 hours × $36 = $405
- Total: about $10,100 a month, roughly $121,500 a year
Gross savings: about $82,500 a year, including roughly 1,260 staff hours and 180 provider hours, before software cost.
Two things stand out. First, provider time is a big share of the value even at one minute per request, because provider time is expensive. Second, the result is very sensitive to the routine share. If 75% of your refills are protocol-eligible instead of 60%, savings rise substantially. If only 40% are, they fall.
Run three versions of the model before you present it: a conservative case (lower routine share, smaller rework reduction), the expected case, and an optimistic one. Partners trust a range more than a single number, and the conservative case is the one that should still justify the decision.
The costs to include
An honest ROI model counts the costs as carefully as the savings.
- Software fees. Pricing models vary: per provider, per location, per request, or as part of a platform. Get a quote on your actual volume.
- Implementation time. Expect an operations lead and a clinical lead to spend part-time hours over several weeks on setup, NextGen connection, and testing.
- Protocol writing. If your refill protocol isn't written down, that's work for your clinical leadership. It pays off whether or not you automate.
- Supervised period. For the first few weeks, staff review every prepared renewal. Savings start small.
- Ongoing oversight. Someone reviews exceptions, audits decisions, and updates protocols. Budget a few hours a week.
In the example above, if software and oversight cost $30,000 to $40,000 a year, net hard-dollar savings are still meaningful. If your volume is a third of that, the math gets much tighter.
The benefits that are harder to quantify
Some of the most persuasive benefits for physician partners don't fit neatly in a spreadsheet. Name them in a separate column so they don't inflate the hard-dollar case.
- Provider inbox relief. Inbox volume is a well-documented burnout driver. The AMA reported Atrius Health cut 50% of prescription-renewal messages reaching physicians through automated protocols, as part of reducing primary care inbox volume by 25%.
- Faster turnaround for patients. Fewer gaps in chronic medications, fewer frustrated calls, and fewer complaints.
- Consistency and auditability. The same protocol applied the same way every time, with a record of why each request went where it did.
- Staff retention. Nurses and MAs spend more time on patient care and less on repetitive chart checks. Replacing an experienced nurse is expensive.
Payback timing and when ROI is thin
For a practice with meaningful volume, a realistic timeline looks like this:
- Months 1–2: Setup, protocol finalization, and supervised operation. Savings are modest.
- Months 3–4: Routine renewals flow with light review. Most of the labor savings appear.
- Months 5–12: Steady state, with protocols expanded to more medication classes as confidence grows.
Practices with several thousand refills a month often see payback on hard-dollar savings within the first year. The ROI is thin when:
- Monthly refill volume is low, a few hundred requests rather than a few thousand.
- Most refills are controlled substances or high-risk medications that must stay with providers.
- There's no written protocol and no appetite to create one.
- Patient and medication data in NextGen are messy enough that exception rates stay high.
If several of these apply, start with protocol writing and data cleanup, or bundle refill automation with other back-office work such as fax triage or prior authorization so shared implementation effort goes further.
Where Honey Health fits in the model
The automation costed above is what Honey Health's Refill agent does. It reads refill requests across eRx, phone, portal, and fax channels, matches patients and medications, checks your protocol against the NextGen chart, prepares routine renewals for provider sign-off, and routes exceptions to the right workgroup with the reason attached. When you build your model, the agent's job maps directly to the “routine share” and “time after automation” assumptions, which are the inputs worth pressure-testing in any vendor evaluation.
Frequently Asked Questions
How do you calculate the ROI of refill automation?
Multiply monthly refill volume by staff and provider minutes per request and by loaded hourly cost, then add the cost of duplicate requests and refill calls. Estimate the same costs after automation, subtract them, and subtract software, implementation, and oversight costs. Keep soft benefits in a separate column.
How much staff time do refill requests take?
It varies by practice and medication mix. Routine renewals with clean data may take a couple of minutes, while unmatched requests or those needing chart research take much longer. A two-week time study of your own staff gives a far more reliable number than an industry average.
What share of refills can be automated?
It depends on your protocol and medication mix. Practices with many maintenance medications and current labs can prepare a large share as routine, while practices with many controlled substances will see less. Your protocol determines the eligible share, not the software.
Does refill automation reduce headcount?
Most practices redeploy the freed time to patient care, prior authorizations, or other backlogs rather than eliminating positions. If headcount reduction is a goal, plan it through attrition and state it plainly in the business case.
How long until refill automation pays for itself?
Practices with several thousand refills a month typically see hard-dollar payback within the first year, after a supervised setup period of one to two months. Lower-volume practices may take longer or see better returns by bundling refill automation with other workflows.
