What moves forward.
Approved scope informs order readiness and billing.
Prior authorizations
Some items or plans require approval before fulfillment, and approvals can have dates, quantities and service limits.
THE OPERATING FLOW
What your team does.
- Identify the responsible payer and current requirement.
- Prepare a cover sheet and attach supporting documents.
- Record approval evidence and monitor consumption or reversals.
When something changes.
A denial, expired authorization or depleted units returns to the request and evidence.
CONTROL POINT
Keep the evidence attached and make the missing information visible.
YOUR IMPLEMENTATION
A submitted authorization is not an approval. Rules vary by item, date, jurisdiction and plan.
Your operation. Your scope.See what changes
See what changes
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BAA and setup before patient data