---
id: inventory-ivr-tracking
title: Track Insurance Verification Requests (IVRs)
module: inventory
audience: [clinician, admin]
roles: [vendor_coordinator, practice_admin, nurse]
type: how-to
estimated_minutes: 5
last_reviewed: 2026-04-24
app_route: /facility/{facility_uuid}/inventory-management
related:
- inventory-overview
- inventory-amniotic-biologics-conservative
- inventory-product-catalog
- inventory-main-inventory
prerequisites:
- inventory-overview
tags: [inventory, IVR, insurance, prior authorization, biologics, graft, payer]
---
# Track Insurance Verification Requests (IVRs)
Submit and monitor Insurance Verification Requests (IVRs) for high-cost graft products to ensure payer authorization is in place before a product is applied.
Submit and track IVRs for skin substitutes — no more spreadsheets.
## Before you start
- The product being ordered must already exist in the **Product Catalog** with a valid HCPCS code.
- You need the patient's active insurance information and the planned date of service.
- The `vendor_coordinator` or `practice_admin` role is required to create and update IVRs.
## What is an IVR?
An **IVR** (Insurance Verification Request) is a prior-authorization record that tracks whether a payer has approved the use of a specific graft product for a specific patient encounter. For biologic and amniotic products, payers commonly require this authorization before the product is applied. Applying without a documented authorization is the most common cause of high-dollar claim denials for graft procedures.
## IVR status lifecycle
IVRs move through the following statuses:
```
Submitted → Pending → Approved
→ Declined → Agreed
```
| Status | Meaning |
|---|---|
| `Submitted` | The IVR has been filed with the payer. The system records the submission date and the submitting user. |
| `Pending` | The payer has acknowledged receipt and is reviewing the request. No decision has been issued yet. |
| `Approved` | The payer has authorized use of the product for this encounter. The product is cleared for application at the planned visit. |
| `Declined` | The payer has denied the request. Do not apply the product until you have either appealed successfully or moved to `Agreed` status. |
| `Agreed` | The patient and provider have agreed to proceed with the product at the patient's financial responsibility after a `Declined` decision, or the payer has issued a formal agreement letter. This status documents that the financial obligation has been disclosed. |
Medicare requires that prior authorization be obtained and documented before applying most skin-substitute products. An IVR in `Approved` or `Agreed` status is your documentation that this step was completed. Do not remove or archive IVR records.
## Submit an IVR
*IVR Tracking table. Status badges update as you advance each IVR through the workflow.*
1. **Open IVR Tracking.** From the **Inventory Management** hub, select **IVR Tracking**.
2. **Create a new IVR.** Click **New IVR** in the upper-right corner of the table.
3. **Select the patient.** Search by last name or date of birth. Confirm the payer shown matches the patient's active primary coverage.
4. **Select the product.** Choose from the **Product** dropdown, which lists only `Active` products with a HCPCS code. The HCPCS populates automatically.
5. **Enter the planned date of service.** This is the visit date when you intend to apply the product, not today's date.
6. **Attach supporting documentation** (if required by the payer). Upload wound photos, measurement records, or clinical notes using **Attach Documents**.
7. **Submit.** Click **Submit IVR**. The record is created with status `Submitted` and a timestamp.
## Advance an IVR through its lifecycle
1. **Mark as Pending.** When the payer acknowledges receipt, open the IVR record and change the status to `Pending`. Enter the payer's reference number if one was issued.
2. **Record the payer decision.** When the payer responds:
- If approved: set status to `Approved`. Enter the authorization number provided by the payer. The product is now cleared for use at the scheduled visit.
- If declined: set status to `Declined`. Document the denial reason in the **Notes** field.
3. **Handle a Declined IVR.** You have two options:
- **Appeal** — Contact the payer and resubmit with additional clinical documentation. Update notes to reflect the appeal date and contact. The status remains `Declined` during appeal unless the payer reverses to `Approved`.
- **Agreed** — If the patient consents to self-pay or the provider accepts financial responsibility, set status to `Agreed` and document the disclosure in **Notes**.
## Result
Each IVR record provides an auditable trail from submission to final disposition. When a clinician opens the Visit Wizard for a patient with an `Approved` or `Agreed` IVR, the associated product is highlighted at step 13 (**Procedure Supplies**) to confirm authorization is on file.
The IVR Tracking table supports filtering by status, payer, and date range. Use these filters at the start of each day to identify IVRs approaching their planned date of service that are still `Pending`.
## Troubleshooting
| Symptom | Likely cause | What to do |
|---|---|---|
| Product not visible in the IVR product dropdown | Product is `Inactive` or has no HCPCS code | Go to **Product Catalog**, confirm the product is `Active` and has a HCPCS code |
| Cannot advance status from `Declined` to `Approved` | Payer has not issued a reversal | Use the **Notes** field to document the appeal and wait for the payer to issue a formal approval |
| IVR shows no patient insurance | Patient's coverage record is missing or expired | Update the patient's insurance in the patient management module before returning to IVR Tracking |
## Related
Auto-rendered from `related:` in frontmatter.