Overview
Prior authorization (PA) is one of the most time-consuming administrative tasks in healthcare. This guide provides best practices to streamline the process and reduce delays.
Step-by-Step PA Process
- Verify PA requirements before scheduling procedures
- Gather all required clinical documentation upfront
- Submit PA requests electronically when possible
- Track all PA requests with status and expiration dates
- Follow up within 48-72 hours if no response
- Document all communications with payers
Pro Tip: Create payer-specific PA checklists to ensure all required information is included on first submission.
Common PA Pitfalls to Avoid
- Starting PA process too close to service date
- Missing required clinical documentation
- Not tracking PA expiration dates
- Failing to obtain PA for out-of-network referrals