Automate Prior Authorization Faxing in Dynamics 365 (Without New Software)
One of the most loathed aspects of healthcare is the prior authorization process. Both the general public and the people handling them often agree the process needs to be improved. It is an operationally expensive process, not only because it's complex but extremely repetitive. You generally have to deal with the below.
- Forms
- Attachments
- Fax numbers
- Case notes
- Follow-ups
And despite the monumental progress we've made with tech in the past decade or so, fax still reigns supreme in this domain. A healthcare org we work with was dealing with a very familiar scenario. The staff was manually copying data from one system into templates, generating PDFs the “old fashioned” way, faxing them through an email gateway, then manually documenting all that transpired.
While this technically works, it's grossly inefficient and error-prone. In addition to this, audit trails were virtually non-existent and the process had no chance of scaling. The first thing that comes to mind for most is to purchase a new system to accommodate their needs. However, given the costs and timelines associated with onboarding a new platform, this simply wasn't feasible. Instead, we took their existing tech stack and morphed it.
Utilizing Power Automate, their existing applications, and Dynamics 365 Customer Service, we crafted the perfect solution in less than a week's time.
The Root Cause: Workflow Segmentation
My client's real issue was not faxing; it was the lack of workflow cohesion. Processes as repetitive as these should live in customizable web applications. Instead, it resided in:
- Desktop house Word templates
- Shared Drives
- Email Inboxes
- Individual staff habits
This leads to inconsistent documentation, unreliable reporting, audit woes, missed deadlines, and follow-ups. The goal here was not to just send faxes faster; it was to convert a manual, clunky, memory-based process into a structured system-driven workflow.
The Design Constraint: Use the Microsoft Stack
This org, like many in the healthcare industry, was firmly rooted in the Microsoft ecosystem. They already had a subscription to Dynamics 365 and Power Automate and an email-to-fax gateway. This was all that we needed to build out the automations needed to optimize their current workflow.
RPA (robotic process automation) would be handled by Power Automate. It's the workhorse of the tech stack and performed the below functions:
- Extract data from Dynamics 365
- Populate the Word templates
- Convert Word templates to PDF
- Send them through the email-to-fax gateway
- Add notes to Dynamics 365 cases
Dynamics 365 is the replacement for spreadsheets. It houses the cases, patients, and the notes associated with the prior authorization process.
The Architecture
Here's a high-level overview of the solution's architecture.
1. Case-Based Trigger in Dynamics 365
The Power Automate flow was triggered only when:
- Case type is Prior Authorization
- Status is Awaiting Outreach
2. Structured Template Population
Instead of having users do this manually, we had Power Automate populate the below info using data from the case in D365:
- Patient demographics
- Doctor information
- Drug details
3. Automated PDF Generation
Staff no longer had to convert Word docs to PDF manually; instead, Power Automate took care of this. Using the built-in Convert To PDF function (Microsoft Word Online - Business), the newly populated Word template is converted to a PDF doc.
Note: Fax-to-email gateways tend to prefer PDFs to Word docs.
4. Email-to-Fax Submission
The flow then:
- Addressed the email using the fax gateway format
- Attached the generated PDF
- Sent the submission
Fax numbers were pulled directly from the doctor's information. This removed one of the most common error points in manual processes. A mistyped fax number results in a failed fax at best and a potential HIPAA violation at worst.
5. Automatic Case Logging and Status Updates
After things successfully completed, Power Automate took the below actions:
- Wrote a note back to the case in D365
- Timestamped the submission
- Changed the case status to Submitted
How This Revolutionized Ops
Pre-automation, staff ran through multiple steps to get faxes out. Tracking was done in a mile-long spreadsheet and errors were subtle but frequent. After automation, staff only needed to update a single field and the system took it from there. We took the gigantic spreadsheet that served as a pseudo-database and added it into D365 so no history would be lost and old records could be added to the new process.
This shift in operations had several benefits including reduced cognitive load, error rate, stress, and operational friction. In this case, automation and AI did not take anyone's job; rather, it made their lives easier. With repetitive friction removed, people could focus on more important things.
The Cost of Implementation
The only cost of this implementation was my labor. No new software had to be purchased, no servers, or any SaaS subscriptions were needed. By utilizing the existing tech, we were able to avoid the cost of user training and the downtime associated with it. This is often an overlooked opportunity in healthcare IT. Organizations frequently underutilize the automation capabilities already included in their licensing.
Pro Tip: Whenever you acquire a new piece of tech, whether it's hardware or software, play around in the settings a bit. There could be all sorts of easter eggs and hidden features awaiting discovery.
Why Prior Authorization Belongs Inside CRM
I've seen prior authorizations tracked in everything from spreadsheets to shared inboxes to sticky notes. These methods are not only inefficient but potentially HIPAA violations.
Prior authorizations touch the following super important areas:
- Members
- Providers
- Clinical documentation
- Financial outcomes
- Compliance obligations
For this reason, they deserve much more than a humble spreadsheet and some complex formulas can offer. When this function resides inside a powerful CRM like Dynamics 365, every action is timestamped and auditable, cases are reportable, and results are easily measurable. Utilizing Super Easy CRM's playbook will evolve your CRM from a mere customer database tool to a powerful, scalable, healthcare-centric ecosystem.
Compliance and Audit Benefits
Healthcare workflows demand traceability. Embedding submission inside Dynamics 365 provides:
- Structured activity logs
- Consistent documentation
- Timestamped automation actions
- Clear submission history
When auditors ask: “When was this submitted?”, the answer is not buried in an inbox. It is tied to the case.
Frequently Asked Questions
Can Dynamics 365 handle prior authorization workflows?
Yes, but only if it's built properly. Case management is a core function of D365 and provides healthcare-centric workflows with all the tools needed to operate securely and efficiently.
Do you need a dedicated fax automation platform?
No, you can get by without a dedicated platform if you utilize a provider with email-to-fax.
How does this improve compliance?
Compliance is improved by producing consistent audit trails that are easily reportable. Additionally, Microsoft provides a BAA that governs most of its products. So chances are, if you've got one signed for Outlook and SharePoint, your D365 and Power Automate are covered as well.
Can this scale for higher volumes?
Yes, this can scale for large enterprises. Just be careful of how you run Power Automate. I've seen flows collide and fail. Be sure to enable parallel runs so you don't have users bumping into each other.
Power Automate supports high-volume workflows when:
- Triggers are scoped correctly
- Required fields are enforced
- Concurrency is configured appropriately
- Logging is structured
Volume requires architectural discipline, not necessarily new tools.
Can this approach track responses?
Yes, with some additional configuration. You'll need to track inbound responses. Once these responses are received, they can trigger new flows, start SLA timers, and update cases. If you're interested in how this would work, feel free to reach out via the links in the author's credit at the end of this article.
What kind of time savings does this provide?
This varies, but one of our clients gained 2.6 hours per FTE (full-time employee) by implementing this workflow.
Is custom development required?
The solution outlined in this article does not require coding. However, certain actions with the Power Automate workflow require the use of Workflow Definition Language (WDL). The syntax is very similar to Excel formulas.
Is this limited to prior authorization?
No, the only limit here is your imagination. We've applied variations of this workflow to:
- Referral submissions
- Appeals
- Clinical documentation requests
- Claims communication
- Compliance documentation
- PTO Requests
- Bug Reports / Feature Requests
What is the most common mistake with automation?
Automating messy processes is the most common mistake I've seen in my 10+ years of experience. Before you even open up Power Automate, you need to define required data elements, trigger conditions, regulatory and business requirements as well as ownership rules. Automation amplifies structure, but it will also amplify chaos if structure is missing.
Optimize what you have, to get where you want
Healthcare organizations often believe operational improvement requires new software. Often it requires better orchestration of existing systems. If you are running Dynamics 365 and Power Automate in a healthcare environment, there may be significant untapped automation potential inside your current stack. Prior authorization is just one example. The real opportunity lies in treating CRM as an operational control system rather than just a record-keeping tool. And, if you're looking for a new CRM, don't go at it blindly. Follow our CRM RFP Guidelines to ensure operational alignment.
Posted by: Matt Irving on 03/01/2026