Prior Authorization Playbook: What Needs PA, Tracking, and No More Missed Visits

WHAT YOU GET

An 8-step prior authorization workflow for small practices, with an editable 11-column PA tracking log and a daily huddle checklist.

FILES

- 04-Prior-Authorization-Playbook.pdf: full-color guide, 6 pages, US Letter

- 04-Prior-Authorization-Playbook-PrintFriendly.pdf: the same 6 pages in low-ink black and white

- editable/Prior-Auth-Playbook-Checklists.docx: Word template

- editable/Prior-Authorization-Tracking-Log.docx: Word template

- README.txt: quick start and license

PAGE COUNT

6 pages (guide, US Letter), plus 2 editable Word templates

FORMAT

US Letter (8.5 x 11 in). PDF (full color and print-friendly black and white) and editable Microsoft Word .docx (also opens in Google Docs and LibreOffice). Delivered as one .zip file.

Instant digital download: your download link appears right after checkout and is emailed to you. No physical item is shipped.

HOW TO EDIT THE WORD FILES

1. Download and unzip the file on a computer.

2. Open any .docx file in Microsoft Word, Google Docs (File > Open > Upload) or free LibreOffice.

3. Optional: click the small header line at the top of the page and type your practice name, or leave it as-is. The templates look finished either way.

4. Type into the tables or edit any wording for your office, then save and print at 100% (actual size).

WHAT'S INSIDE

- An 8-step prior-auth workflow from order to approval

- Services that commonly need PA

- Original Medicare vs Medicare Advantage rules, including the WISeR model and CMS-0057-F decision timeframes

- A 10-minute daily PA huddle checklist

- A risk table for missed and cancelled visits, and what to do when a request is denied

- An editable 11-column PA tracking log (Word)

LICENSE

Print and copy these files for use inside your own practice (one practice). Please do not resell or redistribute them.

PLEASE NOTE

Educational use only. Not legal, billing, coding or medical advice. Rules change and vary by Medicare Administrative Contractor (MAC), state and payer, so confirm with the official sources listed in the file. All examples are fictional. Not affiliated with or endorsed by CMS, HHS, X12 or any payer. CPT(R) is a registered trademark of the American Medical Association; code descriptions are short paraphrases.

AI DISCLOSURE: I wrote this with the help of AI tools and checked it against the official sources listed in the file.

(c) 2026 Clinic Revenue Guidess