How to set up an authorization tracking workflow

Start with a single controlled queue that every authorization request enters, with the payer, the service, the requested units and dates, the ordering provider, the submission date and channel, and the current status. A request tracked in someone's memory or a personal file is a request that gets lost.

Keep patient information in the approved secured system; the tracking structure is an operational index, not a patient record. Use a non-PHI internal reference to tie an entry to the secured record.

Move each request through defined states — submitted, pending, approved, denied, peer-to-peer — and follow up against the payer's stated timeframe rather than an assumed one. A request that stalls without follow-up is where a preventable denial is created.

On approval, record the authorization number, the approved units, and the approved date range. These three facts are what the claim will be reconciled against later, so capturing them at approval saves rework at billing.

For services delivered over time, track units used against units authorized and watch the valid-to date, so a claim never exceeds the approved amount and no service is delivered outside the window. An authorization status log makes the remaining units and the expiry visible before they become a denial.

Flag authorizations that are nearing exhaustion or expiry early enough to renew them, where the plan of care continues. The point of the workflow is to act before the approval runs out, not to discover afterward that it did.

Give the queue an owner and a review cadence. Someone has to be accountable for following up pending requests, reconciling approvals, and escalating the exceptions — a shared queue with no owner is one nobody works.

Review the workflow's outcomes with a stable definition: requests pending beyond the payer's window, services at risk of being delivered without approval, and authorization-related denials by cause. The measures point back to the steps that need tightening.