How to Get Prior Authorization for Vascular Referrals in Wound Care
workflow
A step-by-step workflow for submitting vascular surgery prior auths from a wound care encounter — ABI evidence, payer forms, approval tracking, and expiration alerts.
Prior authorization is the single biggest reason vascular referrals stall in wound care. Here's how to get one submitted, approved, and tracked without leaving the encounter.
Step 1: Gather the clinical evidence
Before you touch a payer form, pull the facts the reviewer will ask for:
- ABI or toe pressure values (e.g., ABI 0.6 = moderate arterial insufficiency)
- Wound duration and non-healing status
- Failed conservative therapies with dates
- Active diagnoses (PAD, diabetes, ulcer location and depth)
Inside WoundScribe, this evidence is already structured on the encounter — no re-abstracting from a narrative note.
Step 2: Open the referral order
From Orders and Rx, tap the vascular surgery suggestion. The New Order form prefills specialty, reason, linked diagnoses, and the ABI value driving the request.
Step 3: Submit to the payer
Attach the auth packet — chart summary, ABI, photos, and prior treatment history — pulled straight from the AI-powered EMR for wound care. Fax or portal-submit to the payer (e.g., Noridian).
Step 4: Track approval and expiration
Once approved, log the auth number (AUTH-58302), expiration date, and upload the approval letter. The referral lifecycle bar moves from Sent → Acknowledged → Scheduled → Seen → Closed, with the auth status visible at every step.
Step 5: Close the loop
When the vascular consult report comes back, attach it to the encounter so the next visit inherits the plan. Documentation stays audit-ready via WISER claims and compliance.