Step-by-Step Instructions

Follow these simple steps to check and submit your prior authorization request

Step 1: Enter Insurance and Procedure Codes

  • Start on the homepage.
  • Before you begin: Make sure you are signed in using the Get Access button at the top of the page.
  • In the form, enter:

    ➡ The name of the Insurance company.

    ➡ One or more CPT codes (up to 10 at once).

  • The system will automatically pull in Procedure names from the database.
  • If your Insurance company is not listed:

    ➡ An error message will notify you: "This Insurer is not currently supported. Please contact us, and we’ll add it promptly."

    ➡ Reach out to support@priorauthspace.com to request adding your Insurer.

    ➡ You will receive a confirmation email once it has been added to the system.

Step 2: Check the Authorization Requirements

  • Click Check to verify which procedures require prior authorization.
  • The results will provide clear, detailed information, including:

    ➡ Whether Prior Authorization is required.

    ➡ The Procedure name and description.

    ➡ Any additional notes, such as required supporting documents.

Step 3: Save or Print the Search Result

  • After reviewing the results, you can keep a copy for your records.
  • To save the result, click the Save button at the bottom of the page. This will store the result locally or generate a downloadable file (depending on your browser settings).
  • To print the result, click the Print button next to Save. You can print to paper or choose “Save as PDF” from the printer options.

Step 4: Submit an Authorization Request

  • For any procedure that requires Prior Authorization, click Submit Authorization (available under each code or at the bottom of the section).
  • Before proceeding, the system will:

    ➡ Prompt you to complete your Profile if not already done.

    ➡ Ask you to sign legal documents via DocuSign.

    ➡ After signing, you’ll see a message: “Documents are being prepared for signing”.

  • Once the status changes to Submit, proceed to the Authorization Form.

Step 5: Complete the Authorization Form

  • The form automatically pre-fills key details such as Insurance information and Procedure codes..
  • Click Upload File to add the Patient’s medical record or referral:

    ➡ The system will extract data to auto-fill the form fields.

    ➡ Review all details for accuracy.

  • Click Submit to [Insurance Name] to send your request.
  • Upon successful submission, you will see a confirmation message with a reference number for tracking.

Step 6: Track Your Request Status

  • Open the Authorizations Dashboard to view all submitted requests.
  • Click on any specific request to see its detailed status and timeline updates.
  • The system may display the following statuses:

    ➡ Submitted — your request has been sent to the payer.

    ➡ Pending Review — the payer is reviewing your request.

    ➡ Additional Info Required — more documents or details are needed.

    ➡ Approved — authorization has been granted.

    ➡ Denied — authorization was not approved.

  • Notifications will be sent via email or mobile alerts when major updates occur.

Step 7: Provide Additional Documents (If Needed)

  • If the Insurance company requests additional information, you will receive a notification with specific details.
  • Collect the required documents, such as updated clinical notes or supporting test results.
  • Upload the additional documents securely through the portal and confirm the submission.

Step 8: Receive the Insurer’s Decision

  • Once the Insurance company completes their review, you will be notified of the decision.
  • The response will include:

    ➡ Approved: You’ll receive an authorization code to share with your Provider.

    ➡ More information required: Follow the request and upload additional materials.

    ➡ Denied: The response will include an explanation of the reasons.

Step 9: File an Appeal (If Necessary)

  • If the request is denied, you have the option to file an appeal.
  • Appeal process:

    ➡ Review the insurer’s explanation for denial.

    ➡ Gather additional documentation or updated notes from your physician.

    ➡ Submit the appeal form along with the required documents.

  • The appeal review may take additional time. Ensure all information is accurate and detailed.
  • The Insurer will provide a final decision after reviewing the appeal.

Step 10: Keep Your Records

  • Always keep records of all submitted forms, communications, and documents related to the authorization process.
  • For urgent cases, contact the insurer directly to request expedited processing.
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