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Early access

Prior authorization automation for medical practices

An early-access workflow for requirements, document collection, submission support, status checks, and EHR updates.

Published Reviewed

Short answer

Prior authorization automation coordinates the non-clinical work around a request: determine requirements, collect approved data and documents, support submission, check status, update the EHR, and route denials or missing information. Clinical decisions remain with qualified staff and the payer.

Where it fits

It fits practices that manage repeat authorization work across payer portals, phone calls, faxes, and EHR queues.

Clark Street is developing prior-authorization workflows through early-access partnerships. Coverage varies by payer, plan, service, and connected system.

A practical workflow

  1. 1

    Determine the requirement

    Check the approved payer source for the patient, plan, service, provider, and date.

  2. 2

    Collect the request packet

    Gather the required administrative fields and identify clinical documents for staff review.

  3. 3

    Support submission

    Use the payer's accepted channel and record the confirmation or reference number.

  4. 4

    Check and record status

    Follow the approved cadence and write each verified update to the EHR or workqueue.

  5. 5

    Route the next action

    Assign missing information, peer review, denial, appeal, or patient communication to the correct owner.

What the practice controls

  • Treat payer and plan requirements as time-sensitive.
  • Keep clinical documentation decisions with qualified staff.
  • Record the source and time of every requirement and status result.
  • Do not present an authorization as a guarantee of payment.

What to measure

  • Requests with complete packets
  • Staff touches per authorization
  • Time waiting for missing information
  • Status checks completed on schedule

Common questions

Is Clark Street prior authorization automation available now?
It is an early-access capability. The first workflow, payers, services, submission channels, and EHR actions are agreed with each partner.
Does the system make a clinical decision?
No. It handles approved non-clinical work and routes clinical questions or documentation review to qualified staff.
Do CMS API rules cover every prior authorization?
No. CMS requirements apply to specified payers and services, with different dates and exclusions. Practices must still verify the current payer and plan process.

Sources and limits

Product scope, payer rules, and connected-system support can change. Review the linked material and confirm the exact workflow before relying on it.

  1. CMS Interoperability and Prior Authorization Final Rule — Official CMS requirements and implementation dates for affected payers.
  2. AMA prior authorization research and reports — Physician research on administrative burden and effects on patient care.
  3. HHS guidance for covered entities and business associates — Official guidance on business associate agreements and safeguards for protected health information.
  4. Clark Street Health product overview — Current patient communication, routing, and EHR workflow scope.

Discuss an early-access workflow

Bring one request type, the rules your staff follow, and the result that belongs in the EHR. We will map the normal path and the exceptions with you.

Book a workflow demo