AUTHORIZATION & SCHEDULING TEAMS
A pending authorization needs a next step.
Hand off the status call, not the clinical decision. Your assistant asks the plan what is happening with the request, what information is missing, and what your team should do next.
See this workflowWhat to have ready
- Patient identity, member ID, and payer contact
- Requested service, procedure, or medication
- Submission date and the authorization or case reference
- Scheduled service date and the staff member for exceptions
THE WORK BEHIND THE CALL
“Still pending” is the start of the conversation.
An authorization coordinator needs more than a status label. The useful questions are whether the request was received, which information is outstanding, which provider and service it covers, and how to follow up. A clear call plan helps turn a long wait into a specific update your scheduling and clinical teams can use.
Start with the right department.
Find published phone, fax and email routes, with source dates and plan-specific details.
Find authorization contactsQuestions worth
getting answered.
- 01
Was the authorization request received and what is its current status?
- 02
If information is missing, what exactly is needed and where should it go?
- 03
What dates, units, services, and provider are associated with the request?
- 04
What follow-up route and timing does the representative recommend?
- 05
If review by a clinician is needed, how does our team arrange it?
What your team
gets back.
- Payer-reported status and case reference
- Missing items and the destination provided by the plan
- Any quoted review or follow-up date
- Questions or decisions that need a staff member
The assistant does not make clinical decisions, establish medical necessity, or guarantee authorization. Clinical questions and decisions stay with the practice.
A few more details.
Prior authorization follow-upDoes DialClerk submit authorizations automatically?
This workflow focuses on phone follow-up using information the office supplies. It does not promise automatic portal submission or EHR integration. Any proposed follow-up message is reviewed by staff before sending.
Can the assistant handle peer-to-peer reviews?
It can ask about the process and record contact details. The actual clinical review and clinical judgment belong to the appropriate licensed professional.
What if the decision will not arrive before the appointment?
The call can flag the timing issue and bring in staff, depending on the selected mode. Your team decides how to communicate with the patient and manage the appointment.
The next thing on your list.
Insurance verification
Delegate payer calls for eligibility and benefits. Gather coverage details, referral requirements, and call references for your medical office to review.
Referrals & records
Follow up with other offices about referral receipt, missing paperwork, and records requests. Keep the next step visible for your team.
LET’S TAKE ONE THING OFF YOUR LIST
Meet your office’s
new calling assistant.
See a workflow. Ask your questions.
Find out where an extra hand would help.