7 Stages of Healthcare Pre-Authorization Workflow

Create a structured workflow: Follow a clear 7-step process from intake to continuous improvement to prevent revenue leaks.
Fix intake first: Capture complete patient, payer, CPT/ICD, and provider details at scheduling to avoid rework.
Submit strong documentation: Use specialty templates and clear medical necessity summaries to reduce denials.
Track and follow up daily: Use a tracker with clear ownership to prevent delays and aging requests.
Act fast on decisions: Link approvals to claims and appeal denials within 48–72 hours.
Measure and improve: Track key KPIs weekly and fix root causes to steadily reduce authorization-related denials.

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Create a structured workflow: Follow a clear 7-step process from intake to continuous improvement to prevent revenue leaks.
Fix intake first: Capture complete patient, payer, CPT/ICD, and provider details at scheduling to avoid rework.
Submit strong documentation: Use specialty templates and clear medical necessity summaries to reduce denials.
Track and follow up daily: Use a tracker with clear ownership to prevent delays and aging requests.
Act fast on decisions: Link approvals to claims and appeal denials within 48–72 hours.
Measure and improve: Track key KPIs weekly and fix root causes to steadily reduce authorization-related denials.