Digital requirements from private insurers for clinics in 2026

Insurers already require digital discipline in authorizations and billing

If your clinic sits in the panel of Adeslas, Sanitas, ASISA, DKV or MAPFRE, more revenue depends on four data points: the prior authorization, its reference number, its validity window and the invoice that cites it. That is where insurers can reject payment today.

Adeslas: published validity and customer-area workflow

Adeslas publishes a 30-day general validity from the date in the request and lets the patient submit through the customer area with a photo of the prescription. The clinic must track that 30-day window per scheduled act.

Sanitas: Mi Sanitas and unique document number

Sanitas separates patient channel (Mi Sanitas) from provider channel (sanitas.es/proveedores). The most fragile administrative item is the unique document number (DU) that appears on the referral.

ASISA, DKV and MAPFRE: each with its own channel and trail

ASISA issues a Service Request form with an identifier number. DKV lets the physician request through its CAP and publishes responses in under 48 hours in Activa DKV. MAPFRE accepts requests via app, web, phone and WhatsApp and runs a professional portal.

EHDS and interoperability: they matter, but they are not the urgency

EHDS and private-health interoperability projects will change clinical data exchange from 2029. It is worth preparing. But revenue loss from poor authorization handling is already happening now.

What the clinic should do this month

Measure monthly volume by insurer, denial rate, expiry rate and approved-but-unbilled authorizations. If the revenue at risk justifies action, the SaludComply authorization diagnostic uses six operational inputs and returns estimated monthly loss, recoverable range and complexity.

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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.

Go to the authorisation diagnostic