Patients
Prior authorization tracking
Never bill a service that needed an authorization you didn't get. Track prior authorizations in a work queue. The scrubber can hard-fail a claim when a required authorization is missing. Missing authorizations are one of the most painful denials because they're often unrecoverable. What ships here includes prior auth tracking queue; status and expiry visibility. Used day to day by biller, supervisor roles, with availability marked available. Open the sample screen on the right, then walk the steps below — or book a demo and put your hand on the same flow with synthetic data.
Claims · all practices
| Claim | Practice | Payer | Amount | Status |
|---|---|---|---|---|
| CLM-24-08812J. Alvarez | Lakeview Ortho | Aetna | $412.00 | Pending review |
| CLM-24-08809R. Chen | Bayside Derm | BCBS | $186.50 | Approved |
| CLM-24-08801M. Okafor | Lakeview Ortho | UHC | $1,204.00 | Submitted |
What it is
Track prior authorizations in a work queue. The scrubber can hard-fail a claim when a required authorization is missing. Electronic 278 capability exists, with production carefully gated.
The problem it solves
Missing authorizations are one of the most painful denials because they're often unrecoverable. Tracking them in a spreadsheet means they slip.
Process
How it works, step by step
- 1
Record the authorization
Add authorizations to the tracking queue as they're requested and approved.
- 2
Watch what's pending
See what's still waiting and what's about to expire.
- 3
Claims check automatically
When an auth is required and missing, the scrubber stops the claim.
- 4
Fix before sending
The biller sees exactly why the claim can't move.
What's included
Everything below is part of prior authorization tracking today.
- Prior auth tracking queue
- Status and expiry visibility
- Scrub hard-fail when auth is missing
- Linked to claims and patients
- Electronic 278 capability (gated)
- Practice-scoped access
The guardrail
A missing authorization stops the claim. It's one of the few places MEDBIX is deliberately strict.
What isn't live yet
Where it fits: the full rcm loop
This is the whole job of a billing company, end to end. Every step lives in MEDBIX, so nothing falls into the gap between two tools.
- MEDBIX
- Clearinghouse / payer
- Person decides
- 1
Patient & insurance on file
MEDBIXDemographics and coverage, from import, EHR ingest or entry.
- 2
Eligibility (270/271)
Clearinghouse / payerCoverage confirmed through the clearinghouse before billing.
- 3
Charge capture → claim draft
Person decidesEncounter becomes a draft claim in the builder.
- 4
Deterministic scrub
MEDBIXRules run; AI can explain any finding.
- 5
Human review & approve
Person decidesRequired before anything leaves.
Audience
Who uses it
These roles work with this feature day to day. Access always follows what your admin assigns.
Works closely with
Deep dive
What Prior Authorization means in daily ops.
Practical context for Prior Authorization: how teams use it, where it sits in the loop, and what to ask in a demo.
- Tied to how billing work actually splits
- Clear on human vs machine responsibility
- Links into related MEDBIX areas
Practice
Where this shows up on a busy day.
From morning eligibility checks to end-of-day posting, Prior Authorization connects to the queues your team already lives in.
- Morning coverage and claim build
- Midday scrub and approval
- Afternoon denials and patient pay
Control
Keep a person on the send button.
Whatever page you're on, MEDBIX keeps AI in a propose role. Approvals, posting and rule activation stay human.
- Named approvals
- Visible AI proposals
- Immutable audit trail
Next
See Prior Authorization against your volume
Bring your payer mix and the friction you feel today. We'll map it onto sample data in thirty minutes.
- Sample data only
- Your questions drive the agenda
- Written follow-up after
Common questions
Can MEDBIX submit authorizations electronically?
The 278 capability exists but production is gated. Tracking is fully available.
Will it block claims?
Yes, when a required authorization is missing.
Can we track auths for every practice?
Yes, scoped to each client practice.
Want to walk MEDBIX against your real claim mix?
Thirty minutes with sample data. We'll follow one claim through the gate, then talk about your payers, practices and where the rework hurts today.
Notes from the billing floor
Occasional, practical writing on denials, A/R and running a billing company. No spam, unsubscribe any time.