Prior-Auth SOP Pack for Practices

Has anyone had surgery auth denials for final coding not being what was anticipated and auth'd

prior to surgery that they've appealed successfully?

“Has anyone had surgery auth denials for final coding not being what was anticipated and auth'd prior to surgery that

they've appealed successfully?” Every authorization event in your practice routes to a named procedure with a named

owner — so the question stops being “what do we do now?” and becomes “which SOP is this?”.

THE PROOF

80.7% of Medicare Advantage prior authorization denials that were appealed in 2024 were partially or

fully overturned — yet only 11.5% of denied requests were appealed at all

Source: KFF, “Medicare Advantage Insurers Made Nearly 53 Million Prior Authorization Determinations in 2024,” January 2026

WHAT IT SETTLES

Stop Rebuilding Your Authorization Process Every Time Something Goes Wrong.

In the package: 113 pages · 5 SOPs · 12 templates · 11 payer scripts · Tracker & payer matrix