5. Review Authorization Statuses

This guide explains how to track and review the status of submitted prior authorizations in exacare.

Step 1: Navigate to Prior Authorizations

a. Go to the Prior Authorizations tab from the screener.

Step 2: Understand the Authorization Table

Within the table, you can view:

• Patient and referral details

• Associated facility (if in all facility view)

• Payer information

• Current authorization status and submission details

• Date of Last Update

• Reference Numbers

Step 3: Filter Authorizations

Use filters to quickly find and view specific authorizations by:

• Facility

• Payer

• Authorization Status

• Date range

Step 4: Review Authorization Status Updates

a. Automatic submissions sync authorization statuses directly from payer portals. While syncing is in progress, an icon will appear in the Last Update column to indicate that statuses are being updated automatically. The sync continues until a final status—such as Approved—is reached.

Statuses include: Submitted, Approved, Denied, Peer-to-Peer or Partial Approval

b. For manual submissions, users must update the authorization status manually.

Statuses include: Pending, Partial Approval, Peer to Peer, Approved, Denied, Cancelled

c. Verify the level at which the authorization was submitted and approved.

Other Features: Hospital-Initiated Authorizations

To review a hospital-initiated authorization:

a. Navigate to the referral where the hospital has already submitted the prior authorization.

b. Select Check hospital-initiated authorization.

c. Review exacare's recommendation. If exacare recommends a higher level of care, you can leave a comment to indicate that a follow-up with the hospital is needed to advocate for the higher level.