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Prior Authorization

Prior authorization request submission and tracking

Complexity: Moderate | Duration: 15-30m | Category: Industry/Healthcare

Tags: prior-authorization authorization payer healthcare

Workflow Diagram​

Steps​

Step 1: Identify requirement​

Agent: authorization

specialist - Determine auth needed

Step 2: Gather documentation​

Agent: clinical

specialist - Compile supporting info

Step 3: Submit request​

Agent: authorization

specialist - Send to payer

Step 4: Track status​

Agent: authorization

specialist - Monitor for response

Step 5: Respond to queries​

Agent: clinical

specialist - Provide additional info

Step 6: Record decision​

Agent: authorization

specialist - Document approval/denial

Step 7: Appeal if needed​

Agent: authorization

specialist - Process appeals

Usage​

To execute this workflow:

/workflow industry/healthcare/prior-authorization.workflow

See other workflows in this category for related automation patterns.