Authorizations are supposed to protect clinics — not destroy their cash flow.
But for most practices, poor authorization management is the #1 silent revenue leak in the entire revenue cycle.

After auditing multiple clinics, one pattern is clear:
Authorizations fail not because teams are careless, but because workflows are broken.

Here are the seven authorization mistakes that cost clinics thousands every month — and how to fix each one.

1. Not Verifying Authorization Requirements Before Scheduling

Most denials start at the front desk.
If schedulers aren’t checking whether a service requires prior authorization before booking the patient, you’re already bleeding revenue.

Fix:
Build a payer-specific “authorization quick-check list” for schedulers so they never guess.

2. Relying on Old or Expired Authorization Data

Many clinics assume old auths carry over — they don’t.
Payers frequently change limits, units, and coverage rules.

Fix:
Use a live tracker that flags:

• expiring authorizations

• low remaining units

• date range conflicts

3. Authorization Doesn’t Match the CPT Codes Being Billed

This is one of the biggest drivers of denials in PT/OT/SLP & BH.
Clinics get auth for one code… but bill another.

Example:
Auth for S5150, but caregiver bills G0156 → instant denial.

Fix:
Always map CPT/HCPCS codes to the exact authorization allowed — no exceptions.

4. Missing Medical Necessity or Documentation Requirements

Many authorizations are approved conditionally.
If documentation doesn’t match the request, payers retro-deny after payment.

Fix:
Standardize documentation templates for evaluations, progress notes, and re-auth requests.

5. Failing to Renew Authorizations on Time

Late renewals create gaps in dates of service — and those claims are dead on arrival.

Fix:
Set automated reminders 7–10 days before expiration.
Assign one team member to own the renewal queue.

6. Billing Services Outside the Authorization Date Range

Even one day outside the range = denial.

Fix:
Ensure your billing system blocks date-of-service creation outside authorized dates.

7. Not Educating Providers & Caregivers on Choosing the Correct Code

You already see this daily:
Caregivers pick random codes in EVV → rejected claims → manual corrections → wasted hours.

Fix:
Provide a simple cheat sheet:
“If X service → select Y code.”
Eliminates 80% of EVV mistakes immediately.

The Bottom Line

Authorizations aren’t complicated — what’s complicated is managing them consistently.

When clinics tighten their authorization workflows, they see:
✔ Fewer denials
✔ Faster payments
✔ Zero compliance risk
✔ Higher cash flow
✔ Less chaos for staff

If your clinic is struggling with auth-related denials, VIS Billing can operationalize the entire process so your revenue stays predictable.