Rekey Desk / Workflows / Prior auth packet building
Prior authorization workflow
Prior authorization packets: chart pages keyed into payer portals
A request lands for a patient your clinic already saw. Your prior auth coordinator pulls the notes, the orders and the prior therapy history, keys them into the payer portal, attaches the pages, then keys the decision back. The clock runs the whole time; the count of open requests is yours.
Rekey Desk writes the Rekey Map for this packet, defines every field in the Field Rulebook, and builds the Keying Build for the portal form. Anything unreadable goes to the Exception Queue with the source page.
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Last updated . Rekey Desk is run by Mike Rodgers from Denver and works remotely with operators across the United States.
What the request carries
A prior authorization request is a form plus proof: clinical notes, orders, prior therapy history, and the pages the payer names. A person keys the form and attaches the proof by hand.
Practices complete 39 prior authorization requests per physician per week, and physicians and staff spend about 13 hours a week on them (AMA, 2025-04-24). 40% of physicians have staff who work only on prior authorizations (AMA, 2025-04-24).
- Medicare Advantage insurers received more than 50 million prior authorization requests in 2023 (KFF via AMA, 2025-04-24).
- They denied 3.2 million in full or part, and 81.7% of appealed denials were overturned (KFF via AMA, 2025-04-24).
- Each one still has to be keyed, attached, tracked and keyed back.
The Field Rulebook for the portal form
Every field gets a source page, a target field, a format rule and a named decider. That is exactly what the Keying Build fills.
Anything unreadable or missing goes to the Exception Queue with a reason code and the source page. Your named decider resolves it.
| Field | Read from | Keyed into | Rule |
|---|---|---|---|
| Member ID and group | Chart face page | Payer portal form | Character for character, spaces included |
| Diagnosis reference | Clinician note | Portal diagnosis field | Copied exactly as documented |
| Prior therapy history | Therapy notes | Clinical history box | Dates and names as printed |
| Payer reference number | Portal confirmation | Authorization tracker | Copied with the date received |
Keying the decision back
Decisions may still arrive by portal, fax, email, mail or phone, and each one has to land in your record (CMS fact sheet, 2024-01-17). The build keys the status, the dates and the denial reason back into the tracker, with the source page attached.
The clock that sets your pace: urgent decisions within 72 hours and standard decisions within 7 calendar days, with a specific denial reason, from January 1, 2026 (CMS fact sheet, 2024-01-17).
What stays with your people
No clinical decisions, no coding decisions, no payer submissions, no calls or appeals on your behalf. Your team submits, your clinician decides medical necessity, and the build only moves what the pages already say.
Bring one recent packet to a teardown: you get the Rekey Map, the Field Rulebook and a fixed build quote.
What correct looks like
The checks behind this page
- Check: every step in the Rekey Map names the chart page it reads from and the portal field it types into.
- Check: every field in the Field Rulebook has a source, a target, a format rule and a named decider.
- Check: the Keying Build keys a held-back sample your staff already keyed, and every mismatch is listed.
- Check: every exception carries a reason code and the source page, and nothing is guessed.
Named owner of mistakes: Mike Rodgers. Every field your staff mark wrong is counted in the Monthly Accuracy Report, the rule behind it is fixed, and the affected records are checked again before the next batch.
Start here
Workflow Teardown, $2,500 fixed
Readout 10 business days after your de-identified sample set arrives. The $2,500 is credited in full against the Keying Build if you sign within 30 days of the readout. If the map shows the workflow is not worth automating, the readout says so, and you keep the map and the rulebook.
The Keying Build is a fixed price quoted after the teardown, and Run and Check is a monthly price quoted with it.
What your people still own
- Your prior auth staff decide what to request and when to appeal.
- Clinicians decide medical necessity and anything clinical.
- Your team submits to payers and takes the calls.
- You own the Field Rulebook, the exception log and the build configuration.
FAQ
Questions about this page
- What does the Workflow Teardown cost?
- It is $2,500 fixed, credited against the build if you sign within 30 days. The readout is due 10 business days after your de-identified sample set arrives, with a Rekey Map, a Field Rulebook, a sample run on 25 documents and a fixed build quote.
- Will you submit the request to the payer?
- No, payer submissions, calls and appeals stay with your team. The build keys your screens and attaches the pages; your staff press send.
- What if the payer still uses fax?
- Fax is still a normal channel: decisions may still arrive by portal, fax, email, mail or phone (CMS fact sheet, 2024-01-17). The build keys whichever channel the decision arrives in, with the source page attached.
- What happens when a page cannot be read?
- It goes to the Exception Queue with a reason code and the source page, and your named person decides it. Mike Rodgers owns every field your staff mark wrong.
Request a sample run
Tell us the workflow that eats the most typing
One short form. We reply by email with what we need for the sample run. No patient data in this form, please.
- Workflow Teardown: $2,500 fixed
- Readout 10 business days after your de-identified samples arrive
- Credited in full against the build if you sign within 30 days