Requests sit without a clear follow-up owner
Clarify ownership and the expected next handoff before creating more work.
Authorization operations
Epic Prior Authorization Workflow: Ownership and Handoffs
Starter guidance for organizing prior-authorization work around ownership, missing information, payer response, scheduling dependencies and exceptions.
What this often looks like
Common symptoms
Scheduling waits on authorization while authorization waits on missing information
Clarify ownership and the expected next handoff before creating more work.
Staff can see status but do not know the next operational action
Clarify ownership and the expected next handoff before creating more work.
Denials and exceptions are handled differently by location or person
Clarify ownership and the expected next handoff before creating more work.
First checks
Work through these before escalating blindly.
- Identify who initiates the authorization workflow
- Name the team responsible for follow-up at each status
- Separate missing information, payer delay, denial and internal routing problems
- Confirm the handoff to scheduling once authorization is ready
- Document the approved exception path for denials and unresolved cases
Ownership questions
- Who owns follow-up with the payer?
- Who owns missing clinical or administrative information internally?
- Who tells scheduling the case is ready?
- Who handles denials and exceptions?
Avoid making the problem worse
Do not use a workaround as the default process.
- Using HelpEpic for medical-necessity decisions
- Interpreting payer policy beyond your authorized role
- Sending patient details or insurance identifiers
- Bypassing required authorization steps to speed scheduling
Security and privacy boundary. Do not send HelpEpic patient names, DOBs, MRNs, insurance identifiers, screenshots, records, passwords, tokens or other confidential information. Access, outages, security incidents, protected configuration changes and patient-specific clinical decisions belong with your organization’s authorized teams.
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