Consulting
Understand what's happening inside your prior authorization workflow
Prior authorization workflows involve more than final decisions. How requests move through the process, where operational problems emerge, and what happens when cases require additional attention all contribute to the day-to-day workload of authorization teams.
The Prior Auth offers focused consulting assessments designed to help healthcare organizations examine these questions using structured workflow interviews, historical case records, or prospective operational documentation.
Each service provides a different kind of visibility, at a fixed project fee. The right approach depends on what you're trying to understand, the information available, and the decisions you need to support.
Explore a consulting engagementThree ways to examine your authorization operations
Workflow Vulnerability Review
Qualitative Workflow Assessment
For organizations asking“Where might our authorization process be vulnerable, and what happens when things don't go as expected?”
This assessment examines how one defined authorization workflow operates, including routine processing, exceptions, delays, unresolved cases, and handoffs between staff or teams.
Through structured interviews with knowledgeable personnel, I develop a high-level picture of the workflow and identify potential vulnerabilities, along with the safeguards staff describe using to manage them.
Best suited for
Organizations that want to understand how a particular workflow functions in practice, investigate recurring operational concerns, or identify areas that warrant closer examination.
What the engagement includes
- One payer/plan pathway, one procedure category, and one authorization workflow
- Up to two structured interviews, each lasting up to 75 minutes
- A high-level current-state workflow map
- A 5–8-page findings report
- Report delivery targeted within 5 business days after the final interview and necessary clarifications
- A 30-minute findings discussion
- One consolidated factual correction round
Important distinctionThis is a qualitative assessment. It does not quantify historical performance, independently verify safeguards, or establish definitive root causes.
Inquire About This ServiceHistorical Workload Assessment
Retrospective Case-Record Analysis
For organizations asking“What do our existing authorization records tell us about case volume, outcomes, and time to resolution?”
This assessment examines up to 90 consecutive calendar days of historical authorization cases within one coherent workflow. The workflow may include multiple payers, plans, and related procedure categories.
Using client-provided case-level records, I analyze how work is distributed, what closing outcomes are recorded, and how much calendar time passes between workflow start and closing disposition.
The analysis distinguishes cases with documented closing outcomes from those that remain open.
Best suited for
Organizations that have historical authorization records but need a clearer, structured understanding of workload patterns, recorded outcomes, and elapsed time to closure.
What the engagement includes
- Up to 90 consecutive calendar days of historical cases
- Data-readiness and extraction guidance
- Validation and analysis of suitable client-provided records
- A 6–9-page findings report with visual summaries of case volume, outcomes, and elapsed time
- Report delivery targeted within 10 business days after dataset acceptance and necessary clarifications
- A 45-minute findings discussion
- One consolidated factual correction round
Important distinctionThis assessment describes patterns in existing records. It does not reconstruct every action taken on a case, measure staff labor hours, or establish why a particular outcome occurred.
Inquire About This Service30-Day Visibility Pilot
Prospective Operational Measurement
For organizations asking“Where do authorization problems first appear, and how much additional work occurs as cases move toward resolution?”
Some of the most important operational activity never appears in a denial rate or a standard authorization dashboard.
The 30-Day Visibility Pilot uses structured prospective documentation to capture what happens as new authorization cases enter and move through one defined workflow.
New cases are enrolled during a 30-day intake period, and participating staff continue documenting meaningful developments and separate actions until those cases close or reach an agreed follow-up cutoff.
I review and analyze the submitted records using The Prior Auth's three-measure Operating View framework:
Authorization Workload
How many cases enter the workflow and how they progress.
Failure Origin
Where the first documented qualifying problem appears, without assuming that this represents the definitive root cause.
Resolution Burden
The number and distribution of qualifying additional staff actions recorded beyond routine processing.
The Operating View framework and related educational resources are available free on the Operating View page. The pilot is the managed engagement in which I apply that framework to your workflow.
Best suited for
Organizations that need visibility into operational problems and additional work that their existing historical records do not adequately capture.
What the engagement includes
- One defined authorization workflow
- A 30-day prospective new-case intake period
- Structured case and event documentation materials
- Setup guidance and ongoing submission review
- Follow-up of enrolled cases through an agreed cutoff
- A comprehensive findings report
- Report delivery targeted within 10 business days after the follow-up cutoff, final submissions, and necessary reconciliation
- An executive findings presentation
Important distinctionThe pilot measures documented operational activity, not labor hours, financial costs, or definitive root causes. It requires an accountable client coordinator and participating staff to maintain the records throughout the agreed collection and follow-up period.
Inquire About This ServiceWhich assessment is right for your organization?
The three services answer different questions.
You don't need to select a service before contacting me.
I begin by understanding the operational question you're trying to answer, what information is available, and what each approach could realistically establish.
If more than one option is appropriate, I'll explain the differences. If your needs fall outside these services, I'll be clear about that as well.
How an engagement begins
1Tell me what you're looking to understand
Send a brief inquiry describing your organization and the operational questions or concerns you’re exploring. You can indicate a service of interest or select "Not sure yet."
2Discuss your objectives
I'll arrange a brief, no-cost conversation to clarify the workflow, your questions, and the type of evidence that would be useful.
3Determine the appropriate approach
I'll recommend a suitable assessment, explain its scope and limitations, and, if you'd like to proceed, send a short written proposal.
Explore a consulting engagement
Whether you're investigating recurring authorization problems, trying to understand historical workload, or looking for better visibility into the work behind your metrics, I'd welcome the opportunity to learn what you're trying to answer.
Prefer email? Contact me directly at ashley@thepriorauth.com
