Medical PA Navigator

The carrier has a clock. You have rights. Let's use both.

Prior authorizations for MRIs, specialist consults, sleep studies, PT series, and similar services aren't open-ended — federal and state rules give the carrier a hard deadline to decide. When they miss it or deny without cause, there are real remedies. This tool shows you your clock, your options, and what to do when the clock runs out.

Step 01.About the service
Clinical urgency

This determines how much time the carrier has to decide — 72 hours vs 15 days.

Optional.

Optional. The doctor whose office submits the PA.

Plan type (if you know)

HDHP usually comes paired with an HSA and has a higher deductible. If your ID card says "HDHP," pick that — plan type can affect how prior auth rules apply.

Step 02.Where are you in the process?
Has the prior authorization been submitted to the carrier?

This is the day your doctor's office sent it to the carrier. If you know the exact day, enter it — this drives your decision clock.

Optional. If you have it, keep it handy here.

What reason did the carrier give for the denial?
Has an internal appeal been filed?
Service-specific context (helps us tailor the plan)

Everything you enter stays on this device. Nothing is sent anywhere unless you choose to download or email it.

Log your calls Helpful if things escalate

If you need to escalate to HR or file an appeal, a clean record of when you called and who you spoke to is your single most important document. This log stays on this device.

If a procedure is coming
Surgery Navigator
Prep the paperwork before the OR date. →
If it’s a prescription
Pharmacy Navigator
Rx denied or priced insane? There’s a path. →
Understand the letter
My insurance denied my claim
What the denial actually means — and your rights. →
A free tool from Dillingham Benefits. Free to share.