Prior Authorization Paperwork Completeness Audit

Check a prior authorization or referral request packet for missing fields, mismatched names and dates, and unclear attachments before it is submitted.

Added October 15, 2026. Written with AI assistance and checked for clarity and placeholders; not reviewed by a lawyer, accountant, clinician or other professional. How these prompts are made

The Open buttons send the prompt text as currently shown below to that site only when you click. Fill in the placeholders first.

[VERIFY] is an editorial flag, not a blank to fill. Wherever the prompt shows [VERIFY], check that item against a reliable source before you use it (what [VERIFY] means).

Please act as a paperwork checker for a prior authorization request that is about to be submitted. Review the administrative completeness only; do not comment on whether the service is medically appropriate.

I will give you: the form fields as text [FORM_FIELDS], the list of attachments I plan to send [ATTACHMENT_LIST], the insurer's stated requirements if I have them [INSURER_REQUIREMENTS], and the submission deadline or appointment date [DEADLINE_DATE]. Replace identifiers with placeholders like "ID-XXXX" before pasting.

Return: (1) a completeness table with columns Item, Required by insurer?, Present?, Problem noticed, Fix, scoring each row Ready / Needs fix / Cannot tell; (2) a consistency check on patient name spelling, date of birth format, member ID format, provider names, dates and codes, listing any place two documents disagree; (3) a count of rows in each status and an overall verdict of Ready, Almost ready or Not ready; (4) a short cover-note template of up to 100 words I can adapt; (5) a submission log template with columns Date sent, Method, Reference number, Person spoken to, Follow-up date.

Guardrails: do not invent insurer requirements; if none are given, use generic checks and label them [VERIFY] against the insurer's own form. Do not fill in clinical fields. Not insurance advice. If something is unreadable, say so rather than guessing.

Add a worked example with invented details: the form shows date of birth 03/04/1980 but the attached letter says 04/03/1980. Show how you would flag it as a Needs fix item and suggest the wording to ask the clinic to confirm.

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