ANSWERS · OPERATIONS

How do I fix my prior-authorization workflow?

You fix prior auth by treating it as a tracked workflow with clear ownership, a due-date before the service, and the auth number linked to the claim — not a task that lives in someone's head. The goal is to never perform an auth-required service without a confirmed authorization on file and attached.

Practice ManagerBilling Lead

Step by step

1
Build a payer-by-service auth grid
Know which services need auth for which plans, so nothing slips because the requirement wasn't obvious.
2
Assign clear ownership
One person or role owns each auth from request to confirmation, with a status you can see.
3
Submit early and track the clock
Start before scheduling where possible; log the request date, expected turnaround, and the auth number.
4
Link the auth to the claim
Attach the confirmed number to the encounter so it's on the claim — an auth that exists but isn't linked still denies.
5
Escalate and appeal fast
For denials, pursue peer-to-peer or retro-auth immediately; the appeal window is short.

Common questions

Can you get a prior authorization after the service?

Sometimes. Many payers allow retroactive authorization for emergent or urgent services, or when eligibility was retro-active. It's worth pursuing before writing the claim off.

Where Volari fits: When a prior-auth denial still lands, Volari works the retro-auth and payer-error appeals that recover a meaningful share.

Related answers
How do I lower my practice's denial rate?How do I reduce days in A/R?How do I read an EOB or 835 remittance?How do I know if I'm being underpaid by insurers?In-house billing vs. outsourcing: which is right for my practice?How do I renegotiate payer contracts for better rates?

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