Prior Authorization Admin Kit | Clinic PA Checklists, Cover Sheet & Tracking Log

The Prior Authorization Admin Kit is a clinic prior auth checklist and tracking template pack for healthcare front-office teams.

It is for medical admin staff who need a printable PA process download to organize cover sheets, payer notes, and denial follow-up.

The ZIP includes a master prior-auth checklist, clinic cover sheet, tracking log, payer-notes blanks, denial follow-up sheet, weekly queue review, plus PDF and editable Word files.

Process templates only. Not medical advice. Not legal advice. Not affiliated with any insurer, PBM, or payer. DCAP does not invent payer requirements. Verify phone numbers, portals, fax lines, forms, and timelines with your clinic contracts before you submit. Single-clinic / single-practice personal use. Not for resale.

What's included

• Print-ready US Letter PDF process pack (~11 pages)
• Cover + how-to with a 10-minute setup rule
• Prior-auth master checklist (start to decision)
• Cover-sheet template with clinic letterhead blanks
• Tracking log (patient / ref / payer / status / dates) in PDF + Excel
• Submission timeline worksheet
• Payer notes sheets labeled for Express Scripts, Centene, Caremark/CVS Caremark, and Tufts (clinic fills contact fields from THEIR contracts; blank extra included)
• Denial / appeal follow-up sheet (process steps blanks)
• Weekly PA queue review checklist
• Editable Word (.docx) mirrors of the main forms
• Excel tracking log ready for Google Sheets import
• LICENSE + README

Who it's for

• Clinic admin and front-office staff who own the prior-auth queue
• Small practices rebuilding PA process from sticky notes and inbox chaos
• Teams that want blank process shells, not fake insurer forms

Who it's not for

• Anyone seeking official payer forms, medical advice, or legal advice
• Anyone wanting PLR / resale / multi-practice redistribution rights
• Anyone expecting DCAP to supply payer phone numbers or requirements

Format & delivery

• Instant digital ZIP after checkout via Shopify Digital Products (gated)
• US Letter PDFs + editable Word/Excel (Sheets-friendly)
• Single-clinic / single-practice use · Not for resale

Price: $32 · SKU DCAP-PA-032

FAQ

Is this an official insurer form pack?

No. These are clinic process templates and blank payer-notes sheets. You fill contacts and rules from YOUR contracts.

Does DCAP give Express Scripts / Centene / Caremark / Tufts phone numbers?

No. Labeled blanks only. Enter what your clinic already has.

Is this medical or legal advice?

No. Process organizers only. Not medical advice. Not legal advice. Not affiliated with any insurer.

Can I use Google Docs / Sheets?

Yes. Upload the Word and Excel files to Drive, or import the .xlsx in Sheets.

Can multiple unrelated clinics share one purchase?

License is single-clinic / single-practice. See LICENSE.txt. Not for resale.

How do I get the files?

Gated download after purchase via Shopify Digital Products. Instant digital download.