Recover denied authorisations: which cases to review first
Not every denied authorisation deserves the same effort. The clinic should distinguish missing documentation, wrong code, invalid prescriber, waiting period, coverage or expired deadline. SaludComply prioritises denials with reasonable amount and recovery probability, and prepares the action for human review.
Which denials can be recovered
The most recoverable denials are usually administrative: missing document, wrong code, insufficient report or mismatched identifier. Coverage or waiting-period denials may require a commercial decision or have low recovery probability.
Calculate revenue lost to authorisations
Use the SaludComply authorisation diagnostic to estimate monthly loss, recoverable range and operational complexity. No patient data required.
Why the queue matters
If the team reviews by arrival order, it mixes small and large cases, recoverable denials and low-probability denials. The queue should sort by amount, urgency and probability.
How SaludComply approaches it
SaludComply classifies the denial reason, calculates amount at risk and proposes an action: complete documentation, correct code, prepare a claim or document low probability. Nothing is sent without clinic approval.
Frequently asked questions
- Can a denied authorisation be recovered?
- Sometimes. It depends on the reason: missing documents, wrong codes or incomplete evidence are usually more recoverable than lack of coverage or waiting period.
Verified sources
- SaludComply — diagnóstico de autorizaciones — diagnóstico de fuga por autorizaciones