shield-checkPrior Authorizations

Create and manage prior authorization requests

Prior authorizations (PAs) are requests submitted to insurance providers to obtain approval before a medical service is performed. Each PA tracks the full lifecycle from creation through approval or denial, including documents, notes, and step therapy history.

Viewing prior authorizations

Navigate to Prior Authorizations from the main menu to see all prior authorizations in a paginated list.

Table columns

Column
Description

ID

Unique identifier (e.g., PA-123)

Patient

Patient name

Status

Current authorization status

Request Date

When the PA was created

Expiration Date

When the authorization expires

Service Date

Expected date of service

Payer

Insurance provider name

Location

Service location

Filtering

Use the filter bar to narrow results by:

  • Status — Pending, Submitted, Approved, Denied, Cancelled, Expired, or Peer to Peer

  • Request Date — date range

  • Service Date — date range

Sorting

Sort by created date, service date, expiration date, next touch date, or patient name — in ascending or descending order.

Use the search bar to find prior authorizations across all text fields.

Creating a prior authorization

  1. Click the Create button to open the creation form.

  2. Select a PA type:

Type
Description

Prescription

Medications and pharmaceuticals

Procedure

Surgeries and medical procedures

Imaging

CT scans, MRIs, PET scans

  1. Fill in the required fields:

Field
Required
Description

Patient

Yes

Select a patient (must have an insurance plan on file)

Insurance Plan

Yes

Select one of the patient's insurance plans

Physician

Yes

Select a healthcare provider

Location

Yes

Select a service location

CPT Codes or Diagnosis Codes

Yes

At least one CPT code or diagnosis code is required

Service Date

No

Expected date of service

  1. Click Create to submit the prior authorization.

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Enable the Create More toggle to keep the form open after saving, allowing you to quickly create multiple prior authorizations in a row.

Creating from a treatment

When linking a PA to a treatment, the physician, location, service date, CPT codes, and diagnosis codes are automatically inherited from the treatment and cannot be edited on the PA form.

Step therapies (Prescription type only)

For prescription-type PAs, you can document previous medications tried before requesting authorization:

  1. Click Add Step Therapy.

  2. Fill in the therapy details:

Field
Required
Description

Medication Name

Yes

Name of the medication from the drug catalog

Medication Dosage

No

Dosage and strength

Start Date

Yes

When the patient started this medication

End Date

No

When the patient stopped

Failure Reason

No

Why this medication was insufficient

  1. Add multiple therapies and drag to reorder them.

AI verification

When a prior authorization is created, the system automatically runs AI-powered verification in the background before submission. This process validates the PA against payer-specific rules and requirements without any manual action needed.

The AI verification checks:

  • Payer rules — whether the procedure or medication is covered by the payer and that all payer-specific requirements and documentation guidelines are met

  • Data completeness — that all required fields and supporting information are present on the PA

  • Submission method — determines the appropriate way to submit to the payer (portal, fax, or phone) based on payer preferences

Once verification completes, results are added as a system-generated note on the PA. If the PA passes validation, it proceeds toward submission. If issues are found, the PA is flagged for manual review.

Prior authorization statuses

Status
Description

Pending

Initial status when a PA is first created

Submitted

Request has been sent to the payer

Approved

Payer has approved the authorization

Denied

Payer has denied the request

Peer to Peer

Requires a peer-to-peer review with the payer

Cancelled

The request has been cancelled

Expired

The authorization has expired

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Prior authorization details

Click on any prior authorization in the list to open its detail page.

Overview

  • PA ID (e.g., PA-123)

  • Status (editable via dropdown)

  • Authorization number (editable — enter the number provided by the payer)

  • Request date

  • Expiration date (editable)

  • Next touch date (editable — for follow-up tracking)

Treatment information

  • Service date, physician, and location

  • CPT codes and diagnosis codes

  • If linked to a treatment, fields are marked as inherited

Step therapies

  • View, add, edit, or remove previous medication therapies

  • Drag to reorder therapies

Right-side panel

  • Patient — patient demographics

  • Insurance — plan type, group number, policy number, effective and expiration dates

  • Documents — upload and manage supporting documents

  • Notes — add notes and comments to the PA

Updating status

From the detail page, use the status dropdown to update the PA status as it progresses through the authorization workflow. Each status change is tracked for audit purposes.

Managing documents

Upload supporting documents (e.g., medical records, letters of medical necessity) from the Documents section on the detail page. Documents can be uploaded via drag-and-drop or file selection.

Adding notes

Open the Notes section on the detail page to add notes or comments related to the prior authorization.

Linking to treatments

Prior authorizations can be linked to treatments. When linked:

  • The PA status is synced to the treatment's workflow steps

  • The PA appears in the treatment's linked records section

  • Treatment fields (physician, location, service date, codes) are inherited by the PA

You can link a PA to a treatment when creating the PA, or from the treatment detail page.

How prior authorizations connect to other features

Feature
Relationship

Treatments

PAs are a workflow step in the treatment lifecycle. Linking a PA to a treatment syncs status updates to the workflow.

PA Determination

A Required determination indicates that a PA should be submitted for the procedure.

Eligibility Checks

Eligibility results may indicate whether prior authorization is needed for covered services.

Payer Network

The payer's contact methods and portal information are used when submitting prior authorizations.

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