Map prior-auth intake before fixing it
Use SIPOC to define the boundaries and handoffs of a prior-authorization intake process before proposing fixes.
The move: do not fix the queue until you can name the whole intake system. SIPOC gives prior-authorization teams a high-level process view before they jump into detailed workflow changes. The goal is not to document every click. The goal is to agree on the process boundary, the required inputs, the outputs, and the people affected by each handoff. Suppliers and Inputs A provider office, portal, fax vendor, eligibility file, or call-center agent can all be suppliers. Inputs include member identifiers, active coverage, diagnosis codes, requested service codes, clinical notes, urgency status, and plan-specific policy requirements. When one input is…
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