Authorization status log
A downloadable CSV structure for reconciling active authorizations against the services billed — without embedding patient data in the example.
CSV · Reviewed 2026-07-18
Download and use
The download contains headings and blank rows only. The examples below use fictional operational references so you can see the intended structure without copying patient data.
Column guide
Internal reference
Use a non-PHI internal work reference.
Payer
Payer or plan name.
Authorization number
The approval's reference number.
Service authorized
A non-clinical description of the approved service.
Units authorized
Approved number of units or visits.
Units used
Units billed against the approval so far.
Valid from
Start of the authorization's date range.
Valid to
End of the authorization's date range.
Status
Active, exhausted, expiring, or expired.
Review date
Next planned reconciliation date.
Fictional example
| Internal reference | Payer | Authorization number | Service authorized | Units authorized | Units used | Valid from | Valid to | Status | Review date |
|---|---|---|---|---|---|---|---|---|---|
| AUTH-LOG-001 | Example payer | REF-AUTH-3001 | Therapy visits | 12 | 5 | 2026-07-01 | 2026-09-30 | Active | 2026-08-01 |
| AUTH-LOG-002 | Example payer | REF-AUTH-3002 | Outpatient procedure | 1 | 1 | 2026-07-10 | 2026-08-10 | Exhausted | — |
Working instructions
- 1Reconcile the units used against the units authorized before billing, so a claim never exceeds the approved amount.
- 2Watch the valid-to date; a service delivered outside the approved window is treated as unauthorized.
- 3Confirm approved units, dates, and any provider or facility restriction against the payer's own record when in doubt.
- 4Do not enter patient names, identifiers, or clinical details in an unsecured copy of this file; keep them in the approved secured system.