Private insurer authorization checklist: 12 controls to stop revenue loss
An authorization checklist for private clinics should cover three moments: before requesting, during the life of the authorization and before billing. Minimum controls are confirming whether the act needs authorization, gathering prescription and code, storing number and channel, tracking expiry, reviewing denials by literal reason and verifying the invoice uses an approved, valid authorization.
How to use this checklist
Twelve controls in three blocks: before the request, during the authorization life, and before billing. Some come from verified insurer documentation; the rest is operating discipline.
Calculate revenue lost to authorisations
Use the SaludComply authorisation diagnostic to estimate monthly loss, recoverable range and operational complexity. No patient data required.
Block 1 · Before requesting the authorization
Block 1: (1) confirm the procedure needs authorization for that insurer/policy; (2) verify the prescribing professional is authorized; (3) gather prescription, code and indication before opening the portal; (4) record the channel used.
Block 2 · During the life of the authorization
Block 2: (5) keep the authorization number next to patient and act; (6) record approval and expiry dates; (7) link to appointment, not a parallel spreadsheet; (8) review at T-7, T-3 and T-1; (9) when rejected, read the literal reason.
Block 3 · Before billing
Block 3: (10) confirm validity at service date, not initial appointment; (11) confirm the invoice number matches the approved authorization; (12) flag approved authorizations not yet billed.
How SaludComply runs this checklist so reception does not have to
SaludComply turns the twelve controls into a visible queue. Nothing goes out without human approval. The clinic team decides; the system prepares.
Verified sources
- Adeslas — Autorizaciones — validez por tipo de servicio y fecha exacta para ingresos e intervenciones
- ASISA — Qué servicios tengo que autorizar — servicios con autorización
- ASISA — Me han denegado una autorización — motivos oficiales de denegación
- Sanitas — Portal de proveedores — canal proveedor y facturación
- DKV — Ahora tu médico puede pedir las autorizaciones por ti — CAP y Plan Libera
- MAPFRE — Solicitar autorización médica — canales app, web, teléfono y WhatsApp