What is an approved-but-unbilled authorization?

It is an authorization the insurer already accepted that never becomes a issued or settled invoice. It can happen even after the service was delivered. It is usually a handoff failure between portal, schedule and billing, not a clinical denial.

How often should the clinic review this queue?

At least weekly before close, and daily if volume is high or several insurers are involved. Prioritize by amount and by delivered acts missing an authorization number on the invoice.

How much can a clinic recover by closing this leak?

SaludComply baseline uses 500 authorizations/month, €200 average value, 8-12% friction and 50-70% recoverable, an indicative range of €4,000-8,400/month. It is not a guaranteed result. The diagnostic calculates it with each clinic’s aggregate figures.

Approved but unbilled authorizations: how clinics recover the revenue

An approved-but-unbilled authorization is an authorized act that never reaches invoice or settlement. Common causes are a missing authorization number link, incorrect invoice data, partial payment or lost handoff between portal, schedule and billing. Clinics should review the authorization → service → invoice → payment chain weekly and prioritize by amount before month close.

By Andrew Swiler · CEO, SaludComply

CEO of SaludComply. Works on authorization automation for Spanish private healthcare and how the main insurers’ provider portals (Adeslas, Sanitas, ASISA, DKV, MAPFRE) operate. Based in Barcelona.

Why approval does not guarantee payment

In many clinics approval is treated as finished work. Real revenue ends when the invoice is issued correctly and settled. In between sit gaps: missing authorization number, mismatched code, wrong professional or site, or a delivered service nobody billed.

Calculate revenue lost to authorisations

Use the SaludComply authorisation diagnostic to estimate monthly loss, recoverable range and operational complexity. No patient data required.

Go to the authorisation diagnostic

Signals of approved-but-unbilled authorizations

Review approved authorizations without an invoice, invoices with incomplete numbers, partial payments versus expected tariff, delivered services without a valid reference and administrative rejections that can still be fixed.

Minimum weekly queue for management

A useful queue sorts by amount at risk and deadline urgency. Each row should show insurer, status, appointment or service date, authorization number, estimated amount and next action: bill, correct, claim or close.

How SaludComply handles it

SaludComply prioritizes approved-unbilled acts alongside denials and expiries. It prepares the next administrative action and leaves final approval with the clinic. The authorization diagnostic estimates monthly revenue at risk from aggregate figures before a demo or paid plan.

Frequently asked questions

What is an approved-but-unbilled authorization?: It is an authorization the insurer already accepted that never becomes a issued or settled invoice. It can happen even after the service was delivered. It is usually a handoff failure between portal, schedule and billing, not a clinical denial.
How often should the clinic review this queue?: At least weekly before close, and daily if volume is high or several insurers are involved. Prioritize by amount and by delivered acts missing an authorization number on the invoice.
How much can a clinic recover by closing this leak?: SaludComply baseline uses 500 authorizations/month, €200 average value, 8-12% friction and 50-70% recoverable, an indicative range of €4,000-8,400/month. It is not a guaranteed result. The diagnostic calculates it with each clinic’s aggregate figures.

Verified sources

DGSFP — Memoria del Servicio de Reclamaciones 2024 — contexto regulatorio sobre rechazo del siniestro en salud