Excel: Build a Prior Authorization Denial Tracker

What You'll Get

A structured denial tracking spreadsheet that captures PA submission data, denial codes, follow-up status, and appeal outcomes — giving you the data you need to identify patterns and reduce future denials.

Why This Tool

PA Specialists who track their denials systematically can identify patterns (specific payers, specific procedures, specific denial codes) that are fixable with process changes. Without a tracker, you're reacting to individual denials without seeing the bigger picture. This tracker is the foundation of a denial reduction program.

Setting Up the Tracker

Sheet 1: Denial Log Create columns for:

• Submission Date
• Payer Name
• Procedure/Service Type (CPT code + description)
• Specialty / Ordering Provider
• Denial Date
• Denial Code (CAS/CARC code)
• Denial Reason (plain language description)
• Preventable? (Yes/No/Unknown)
• Root Cause (Missing documentation / Wrong code / Step therapy not met / Eligibility / Policy exclusion / Other)
• Action Taken (Appeal submitted / P2P requested / Patient notified / Written off)
• Appeal Outcome (Approved / Denied / Pending)
• Days to Resolution
• Notes

Sheet 2: Payer Summary Use COUNTIF and SUMIF formulas to aggregate by payer:

• Total submissions (from a submissions log)
• Total denials
• Denial rate %
• Most common denial reason per payer
• Appeal overturn rate %

Sheet 3: Procedure Type Summary Same aggregation by CPT code or service category — shows which services generate the most denials.

Sheet 4: Monthly Trend Chart total denials by month with a trend line. Track whether process changes are working.

Key Formulas

Denial Rate = COUNTIF(DenialLog[Status],"Denied") / COUNTA(SubmissionLog[Date])
Appeal Overturn Rate = COUNTIF(DenialLog[Appeal Outcome],"Approved") / COUNTIF(DenialLog[Action Taken],"Appeal submitted")
Avg Days to Resolution = AVERAGE(DenialLog[Days to Resolution])

Monthly Review Routine

1. Export all denials from Availity and payer portals for the month
2. Add to the denial log sheet
3. Review Sheet 2 and 3 for new patterns
4. Identify 1–2 root causes to address the following month
5. Share the trend chart with your supervisor

Using AI With This Tracker

Once you have a month of data, copy the Payer Summary table and paste it into ChatGPT or Claude with the prompt: "Analyze these prior authorization denial patterns. What are the most significant issues and what process changes would have the most impact?" This turns your raw data into actionable recommendations.