Who is responsible for submitting an authorization request to the insurer using a patient's medical records?

The responsibility for submitting an authorization request to the insurer using a patient's medical records typically falls on the provider's office staff. This is because the staff members are directly involved in managing the administrative tasks related to patient care, including obtaining prior authorizations.

When a healthcare provider decides that a specific procedure, treatment, or service requires prior authorization, their office staff gathers the necessary medical records and information to complete the request accurately. This includes not only clinical notes and test results but also ensuring that all documentation aligns with the payer's requirements for approval.

The other options—such as the patient, billing specialist, and insurance agent—do not typically handle the submission of authorization requests in this context. The patient may be involved in the process by providing information or consent, while billing specialists focus more on claims submissions and financial aspects rather than handling prior authorizations. Insurance agents primarily serve as intermediaries between the insurer and the client, rather than processing requests for individual patient services. Thus, the provider's office staff is best positioned to ensure that the authorization request is thorough and correctly submitted.