Prior authorizations in private clinics: where revenue is lost
Prior authorization is a revenue process, not only admin
In many clinics, authorizations live at reception: calls, PDFs, portals, reminders and spreadsheets. But the final impact is managerial: services performed but not paid, delayed tests, cancellations and rejected invoices.
The five points where the process breaks
The process breaks on small details: a late request, a clinical note that does not justify the act, a wrong code, an unchecked portal status or an authorization that expires before the appointment.
What a clinic should measure every week
Measure volume by insurer, denial rate, expiry rate, resubmissions, average time to approval and approved authorizations pending billing. A clean four-week table often reveals the real problem size.
When does automation make sense?
It makes sense when a clinic has more than roughly 200 authorizations per month, works with three or more insurer portals, or has at least one part-time person chasing statuses and expiries.
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Calculate revenue lost to authorisations
Use the SaludComply authorisation diagnostic to estimate monthly loss, recoverable range and operational complexity. No patient data required.