Private insurer authorization checklist: 12 controls to stop revenue loss

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.

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

Related pages

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