How to use the template
- Use one row per provider request. Split record types into separate rows when they go to different contacts.
- Record the authorization, proof of sending and next follow-up date before moving to Sent.
- Review overdue requests, partial records, missing authorizations and requests past your firm’s follow-up interval each week.
Download the workbook for all tabs, or use the CSV for a single table. To use Google Sheets, upload the Excel file or import the CSV. Delete the example rows and the final NOTE row in each CSV before adding your own records. Store files in your firm’s approved system and link to them; keep passwords, identity numbers and document contents out of the tracker.
Tracker
Tracker| Case | Provider | Records contact | Record type | Dates of service requested | Authorization on file | Date sent | Proof of sending | Next follow-up date | Status | What's missing | Owner | Reviewed by | Notes |
|---|
| EXAMPLE 24-118 | City urgent care | Records dept, fax | Records | 3 Mar to 3 Mar | Yes, signed 10 Mar | 12 Mar | Fax confirmation | 26 Mar | Sent | — | Paralegal A | — | — |
| EXAMPLE 24-118 | Orthopedic group | Retrieval company portal | Records + itemized bill | 10 Mar to 30 Jun | Yes, signed 10 Mar | 14 Mar | Portal receipt | 28 Apr | Partial | Bill received, no visit notes after 2 May | Paralegal A | Paralegal B | — |
| EXAMPLE 24-131 | Imaging center | — | Imaging report | 18 Apr to 18 Apr | No | — | — | — | Not sent | — | Intake C | — | Chase client for signed authorization first |
Duplicate check
Duplicate check| What you find | What to do |
|---|
| No row for this provider on this case | Send the request |
| An open row covering the same dates and record type | Don't send. Follow up on the open one instead |
| An open row covering some of the dates | Ask the case owner whether to send a new request only for the gap |
| A Complete row, with more treatment since | Send a new request for the new dates only |
| A Cancelled row | Read the note to see why before sending anything |
Incomplete check
- Do the records cover the full date range you asked for?
- Did every record type come back? Notes, bills and imaging reports often arrive separately.
- If you asked for a certification or an itemized bill, is it there?
- Does the page count look right for the number of visits? Note the count in Notes.
- If anything is missing: set Status to Partial, write exactly what's missing, set a new follow-up date, send to the person in Reviewed by.
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