Expired authorization in private insurance: what to do and how to avoid it
An expired authorization is not an admin mistake, it is revenue at risk
When the authorization expires before the appointment, the clinic has three options, none of them good: reschedule, perform the act without valid cover or rush a renewal. All three cost money.
Calculate revenue lost to authorisations
Use the SaludComply authorisation diagnostic to estimate monthly loss, recoverable range and operational complexity. No patient data required.
Why authorizations expire
Insurers set validity by type of service. Adeslas publishes 90 days for medical tests, analyses, rehabilitation and psychotherapy; admissions and interventions require an exact date. No uniform public rule has been verified for MAPFRE, Sanitas or DKV.
What to do when the authorization has already expired
First, do not perform the act assuming a later renewal. Expired authorizations rarely reactivate without a new request. Then recover prescription, original report, expired number and real appointment date, request renewal with the prior number and clinical justification, and log status and new validity in writing.
How SaludComply prevents expiry
SaludComply treats every authorization as a queued item with a visible expiry. The agent flags approaching limits and proposes renewal or rescheduling before the appointment lands.
Frequently asked questions
- What should I do if a private insurance authorisation has already expired?
- Do not perform the act assuming a later renewal: an expired authorisation rarely reactivates without a new request. Recover the prescription, the original report, the expired authorisation number and the real appointment date, and request the renewal quoting the prior number and the current clinical justification. Log the new status and new validity date in writing before moving the schedule.
- How long is an authorisation valid in private insurance?
- It depends on the insurer and service. Adeslas publishes 90 days for medical tests, analyses, rehabilitation and psychotherapy; admissions and interventions require an exact date. No uniform public rule has been verified for MAPFRE, Sanitas or DKV.
- How does SaludComply stop an authorisation expiring before the appointment?
- The agent treats every authorisation as a queued item with a visible expiry date and flags reception when an approved authorisation nears its limit window, proposing renewal or rescheduling. Human approval is mandatory before each submission: the agent never renews on its own, it only prepares the work for the team to decide.
Verified sources
- Adeslas — Autorizaciones — plazos por tipo de acto
- MAPFRE — Solicitar autorización médica — canales y trámite paciente